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1104972033
BRIAN M THIELEN
GREEN BAY, WI
NPI
1104972033
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WI 4725)
Enumeration Date
2007-01-25
Last Update Date
2007-07-08
Business Address
Dr. BRIAN M THIELEN dmd
1543 PARK PL SUITE 300
GREEN BAY, WI 54304-1970
Phone number: 920-405-3600
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Mailing Address
Dr. BRIAN M THIELEN dmd
1543 PARK PL SUITE 300
GREEN BAY, WI 54304-1970
Phone number: 920-405-3600
Copy
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