Individual
THIAGO DIAS NASCIMENTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
675 E NICOLLET BLVD STE 255, BURNSVILLE, MN 55337-6768
(952) 892-6222
(952) 892-6477
Mailing address
3475 PLYMOUTH BLVD STE 200, PLYMOUTH, MN 55447-1539
(763) 577-2484
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
S196
MN
1223X2210X
Orofacial Pain Dentistry
Primary
S196
MN
Other
Enumeration date
02/22/2023
Last updated
11/04/2024
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