Provider Demographics
NPI:1639388655
Name:THELEN, ANN STONE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:STONE
Last Name:THELEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLD SPRING
Mailing Address - State:MN
Mailing Address - Zip Code:56320-2323
Mailing Address - Country:US
Mailing Address - Phone:320-685-3564
Mailing Address - Fax:320-685-3961
Practice Address - Street 1:411 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLD SPRING
Practice Address - State:MN
Practice Address - Zip Code:56320-2323
Practice Address - Country:US
Practice Address - Phone:320-685-3564
Practice Address - Fax:320-685-3961
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND9266122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist