DR. Mimi Theerathada, DMD

NPI #1528256369 in Westminster, California

Provider Information

NPI Number: 1528256369
Entity Type: Individual
Name: DR. Mimi Theerathada, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Oct 5, 2007
Last Updated: Feb 21, 2017

Practice Location

Address: 9972 BOLSA AVE
Address 2: 102
City: Westminster
State: California
ZIP Code: 92683-6069
Phone: (714) 839-3112

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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