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Individual

DR. KRISTA MONIQUE THELEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
11269 JEFFERSON HWY N, CHAMPLIN, MN 55316-3123
(763) 421-5206
(763) 421-8320
Mailing address
10054 JAMES AVE NE, MONTICELLO, MN 55362-4312
(612) 743-3657

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11969
MN

Other

Enumeration date
12/08/2006
Last updated
07/08/2007
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