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NPI Profile for NICHOLAS P THEBERGE in GREENFIELD, MA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Oral & Maxillofacial Surgery |
204E00000X | 02 | Physician/General Surgery |
| NPI # | 1346580974 |
|
| Status | Active | |
| Credentials | DDS (Doctor of Dental Surgery) | |
| Entity | Individual | |
| Enumeration date | 02/19/2013 | |
| Last updated | 06/10/2025 - About 12 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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NICHOLAS P THEBERGE
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NICHOLAS P THEBERGE, DDS