Individual
TODD ANTHONY THAYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1050 LARPENTEUR AVE W, SAINT PAUL, MN 55113-6556
(651) 488-5622
(651) 489-2856
Mailing address
1050 LARPENTEUR AVE W, SAINT PAUL, MN 55113-6556
(651) 488-5622
(651) 489-2856
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10589
MN
Other
Enumeration date
10/05/2011
Last updated
10/05/2011
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