Organization
DISTINCTIVE DENTAL SERVICES, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN THOENNES DDS (CEO)
(320) 485-4344
Entity
Organization
Contact information
Practice address
131 MAIN AVE W, WINSTED, MN 55395-7873
(320) 485-4344
(320) 485-4734
Mailing address
131 MAIN AVENUE WEST, BOX 599, WINSTED, MN 55395-0599
(320) 485-4344
(320) 485-4734
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/26/2007
Last updated
07/29/2008
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