Individual
NATHAN THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
315 E MAIN ST, NILES, MI 49120-2365
(269) 684-2355
Mailing address
315 E MAIN ST, NILES, MI 49120-2365
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
2901021187
MI
Other
Enumeration date
06/19/2015
Last updated
06/19/2015
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