Individual
DR. JEREMEY J THIETTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
924 S LINCOLN AVE, LAKEVIEW, MI 48850-9174
(989) 352-6477
(989) 352-8348
Mailing address
924 S LINCOLN AVE, PO BOX 530, LAKEVIEW, MI 48850-9174
(989) 352-6477
(989) 352-8348
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901019669
MI
122300000X
Dentist
5315032828
MI
Other
Enumeration date
03/03/2008
Last updated
04/03/2009
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