Individual
PAMELA A THIESING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13380 W TREPANIA RD, HAYWARD, WI 54843-2186
(715) 638-5100
(715) 634-6107
Mailing address
13380 W TREPANIA RD, HAYWARD, WI 54843-2186
(715) 638-5100
(715) 634-6107
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
1001802-016
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
WI
Enumeration date
04/16/2008
Last updated
04/16/2008
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