Individual
JOSEPH RAYMOND THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1102 REGIS CT, EAU CLAIRE, WI 54701-4404
(715) 834-2032
(715) 552-1552
Mailing address
1102 REGIS CT, EAU CLAIRE, WI 54701-4404
(715) 834-2032
(715) 552-1552
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5000361-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33658100
—
WI
Enumeration date
08/13/2006
Last updated
07/09/2007
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