DR. Timothy Allen Theisen, DDS, MS

NPI #1700982378 in Rockford, Illinois

Provider Information

NPI Number
1700982378
Entity Type
Individual
Name
DR. Timothy Allen Theisen, DDS, MS
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Dentist - Orthodontics and Dentofacial Orthopedics
Credential
DDS, MS
Enumeration Date
Sep 15, 2006
Last Updated
Aug 25, 2007

Practice Location

Address
6050 BRYNWOOD DR
Address 2
SUITE 201
ZIP Code
61114-6579
Phone
(815) 877-7079

Specialties & Taxonomy Codes

Specialty
Dentist - Orthodontics and Dentofacial OrthopedicsOrthodontics and Dentofacial Orthopedics

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