Dr Mark Benjamin Thiele, DDS is a medicare enrolled "Dentist" provider in Warroad, Minnesota. His current practice location is
301 State Ave Sw, Warroad, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 386-1048.
Dr Mark Benjamin Thiele is licensed to practice in Minnesota (license number D13533) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1073994653.
Healthcare Provider's Profile
Full Name | Dr Mark Benjamin Thiele |
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Gender | Male |
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Speciality | Dentist |
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Location | 301 State Ave Sw, Warroad, Minnesota |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1073994653
- Provider Enumeration Date: 06/09/2015
- Last Update Date: 03/16/2018
Medicare PECOS Information:
- PECOS PAC ID: 9638476021
- Enrollment ID: I20160330001333
Medical Identifiers
Medical identifiers for Dr Mark Benjamin Thiele such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073994653 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | D13533 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark Benjamin Thiele is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Mark Benjamin Thiele, DDS Po Box 490, Warroad, MN 56763-0490 Ph: (218) 386-1048 | Dr Mark Benjamin Thiele, DDS 301 State Ave Sw, Warroad, MN 56763-2623 Ph: (218) 386-1048 |
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