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HALEY LEA THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LDH ADT

Contact information

Practice address
115 DREW AVE SE, MADELIA, MN 56062-1873
(507) 642-8742
Mailing address
233 GILBERT AVE SW, MADELIA, MN 56062-1251
(651) 500-8463

Taxonomy

Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
H10214
MN
125J00000X
Dental Therapist
DT109
MN
125K00000X
Advanced Practice Dental Therapist
Primary
ADT109
MN

Other

Enumeration date
04/25/2019
Last updated
09/29/2021
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