Provider Demographics
NPI:1952510547
Name:ROBERT R. THEIL D.D.S. AND THOMAS D. THEIL D.D.S., INC.
Entity Type:Organization
Organization Name:ROBERT R. THEIL D.D.S. AND THOMAS D. THEIL D.D.S., INC.
Other - Org Name:THEIL AND THEIL, D.D.S., INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:D
Authorized Official - Last Name:THEIL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:937-233-7121
Mailing Address - Street 1:5509 BRANDT PIKE
Mailing Address - Street 2:
Mailing Address - City:HUBER HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:45424-6117
Mailing Address - Country:US
Mailing Address - Phone:937-233-7121
Mailing Address - Fax:
Practice Address - Street 1:5509 BRANDT PIKE
Practice Address - Street 2:
Practice Address - City:HUBER HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:45424-6117
Practice Address - Country:US
Practice Address - Phone:937-233-7121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH310201601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty