Mario Thevenin
Mario Thevenin is a Student in an Organized Health Care Education/Training Program in Brockton, Massachusetts. Works from 2 locations. Licensed in Massachusetts.
- Licensed in
- MA
- In the registry since
- 2023
- Specialties on file
- 2
Practice location Address checks out
Brockton, MANo coordinates on file. Search this address in Google Maps
Additional practice locations (1)
- 345 E 24th St, New York, NY 10010-4020 — (212) 998-9800
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence DN10000926 (MA) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1932886066 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 30, 2023 |
| Last updated in NPPES | July 4, 2025 |
| Certification date | July 4, 2025 |
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