Individual
DR. JEFF THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD, MSD
Contact information
Practice address
435 WILLARD AVE, NEWINGTON, CT 06111-2318
(860) 666-2009
Mailing address
435 WILLARD AVE, NEWINGTON, CT 06111-2318
(860) 666-2009
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
009054
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
055860
NY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
DE00009909
WA
Other
Enumeration date
07/27/2009
Last updated
03/20/2013
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