MR. Timothy Mcmichael Theisen, DMD

NPI #1003259797 in Erie, Pennsylvania

Provider Information

NPI Number: 1003259797
Entity Type: Individual
Name: MR. Timothy Mcmichael Theisen, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Apr 11, 2013
Last Updated: Aug 9, 2021

Practice Location

Address: 4330 PEACH ST
City: Erie
State: Pennsylvania
ZIP Code: 16509-1443
Phone: (814) 315-6209

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Prosthodontics — Prosthodontics	1223P0700X
Dentist	122300000X	Primary

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