Organization
CRAIG C. THIEDE DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CRAIG THIEDE (OFFICE MANAGER)
(714) 730-6767
Entity
Organization
Contact information
Practice address
13132 NEWPORT AVE STE 230, TUSTIN, CA 92780-3429
(714) 730-6767
(714) 730-1161
Mailing address
13132 NEWPORT AVE STE 230, TUSTIN, CA 92780-3429
(714) 730-6767
(714) 730-1161
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/11/2020
Last updated
02/24/2023
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