Female

Kathleen V. Thieu

Periodontist in Lake Elmo, MN(View on Map)

Full Name

Kathleen Van Thieu

NPI Number

1588194567

NPI Type

Individual Provider

Gender

Female

Enumeration Date

06/13/2017

Specialties

(Taxonomies)

Code

1223P0300X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

D13834

Contact
Information

Purpose

Mailing
Location

Address

2200 COUNTY ROAD C W STE 2210
8650 HUDSON BLVD N STE 105

City

Roseville
Lake Elmo

State

MN
MN

Postal Code

55113-2551
55042-8416

Country

US
US

Telephone Number

(651) 746-2815
(952) 444-9511

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 12/03/2020

Provider Address

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