Thayer Orthodontics | |
1050 Larpeuteur Avenue West St Paul MN 55113-6556 | |
(651) 488-5622 | |
(651) 489-2856 |
Full Name | Thayer Orthodontics |
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Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
Location | 1050 Larpeuteur Avenue West, St Paul, Minnesota |
Authorized Official Name and Position | Todd Anthony Thayer (PRESIDENT ORTHODONTIST) |
Authorized Official Contact | 6514885622 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Thayer Orthodontics 1050 Larpeuteur Avenue West St Paul MN 55113-6556 Ph: (651) 488-5622 | Thayer Orthodontics 1050 Larpeuteur Avenue West St Paul MN 55113-6556 Ph: (651) 488-5622 |
NPI Number | 1407923733 |
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Provider Enumeration Date | 11/30/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407923733 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | MN10589 (Minnesota) | Primary |
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