Individual
DR. MARYEVAN SHEPPERD THACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1057 NIMITZVIEW DR, CINCINNATI, OH 45230-4359
(513) 232-1600
Mailing address
1057 NIMITZVIEW DR, CINCINNATI, OH 45230-4359
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
30.024135
OH
Other
Enumeration date
07/20/2017
Last updated
07/20/2017
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