Provider Demographics
NPI:1619059961
Name:THIEL, JAMES NICHOLAS (DDS)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:NICHOLAS
Last Name:THIEL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:ONE BROOKLINE PLACE
Mailing Address - Street 2:SUITE 506 DRS THIEL RUBIN WANG INC
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445
Mailing Address - Country:US
Mailing Address - Phone:617-735-8660
Mailing Address - Fax:617-735-8662
Practice Address - Street 1:ONE BROOKLINE PLACE
Practice Address - Street 2:SUITE 506 DRS THIEL RUBIN WANG INC
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445
Practice Address - Country:US
Practice Address - Phone:617-735-8660
Practice Address - Fax:617-735-8662
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA104051223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics