Individual
NICOLE THIELER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
206 MYSTIC BLVD, HOUMA, LA 70360-2762
(985) 876-4484
(985) 876-4498
Mailing address
206 MYSTIC BLVD, HOUMA, LA 70360-2762
(985) 876-4484
(985) 876-4498
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6289
LA
Other
Enumeration date
08/13/2014
Last updated
02/27/2015
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