Distinctive Dental Services PA

NPI #1144484205 in Hilltop, Minnesota

Provider Information

NPI Number
1144484205
Entity Type
Organization
Organization Name
Distinctive Dental Services PA
Subpart
Yes (part of a larger organization)
Parent Organization
DISTINCTIVE DENTAL SERVICES, PA
Primary Specialty
Dentist - General Practice
Enumeration Date
Jul 17, 2008
Last Updated
Jul 17, 2008

Practice Location

Address
4716 CENTRAL AVE NE
ZIP Code
55421-1944
Phone
(763) 572-9762

Authorized Official

Name
DR. MICHAEL JOHN THOENNES, DDS
Title
CEO
Phone
(763) 572-9762

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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