TIMOTHY ALLEN THEISEN

ROCKFORD, IL
NPI1700982378
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IL  021.001445)
Enumeration Date2006-09-15
Last Update Date2007-08-25
Business Address
Dr. TIMOTHY ALLEN THEISEN DDS, MS
6050 BRYNWOOD DR SUITE 201
ROCKFORD, IL 61114-6579
Phone number: 815-877-7079
Mailing Address
Dr. TIMOTHY ALLEN THEISEN DDS, MS
6050 BRYNWOOD DR SUITE 201
ROCKFORD, IL 61114-6579
Phone number: 815-877-7079
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