| Craig C. Thiede DDS | |
|
13132 Newport Ave Ste 230 Tustin CA 92780-3429 | |
| (714) 730-6767 | |
| (714) 730-1161 |
| Full Name | Craig C. Thiede DDS |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 13132 Newport Ave Ste 230, Tustin, California |
| Authorized Official Name and Position | Craig Thiede (OFFICE MANAGER) |
| Authorized Official Contact | 7147306767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig C. Thiede DDS 13132 Newport Ave Ste 230 Tustin CA 92780-3429 Ph: (714) 730-6767 | Craig C. Thiede DDS 13132 Newport Ave Ste 230 Tustin CA 92780-3429 Ph: (714) 730-6767 |
| NPI Number | 1841892148 |
|---|---|
| Provider Enumeration Date | 11/11/2020 |
| Last Update Date | 02/24/2023 |
| Certification Date | 02/24/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841892148 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (NU) | Primary |
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