Individual
DR. DEEP MANOJ THAKKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1931 MAIN ST, GREEN BAY, WI 54302-3920
(920) 499-2770
Mailing address
1931 MAIN ST, GREEN BAY, WI 54302-3920
(920) 499-2770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
600162615
WI
Other
Enumeration date
07/20/2024
Last updated
07/20/2024
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