| NPI | 1417356684 |
|---|---|
| Former Name | NICOLE ELIZABETH THIELER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: LA 6289) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2015-02-27 |