Individual
TIMOTHY JOHN THEWES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
25225 W 7 MILE RD # 100, REDFORD, MI 48240-1462
(248) 408-7048
Mailing address
824 N ALTADENA AVE, ROYAL OAK, MI 48067-3610
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901022039
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2016
Last updated
08/20/2020
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