Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mario Thevenin

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1932886066

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

698 Crescent St
Brockton, MA 02302-3360
Phone: (508) 583-2256
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

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 number1932886066
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 30, 2023
Last updated in NPPESJuly 4, 2025
Certification dateJuly 4, 2025
Mailing address6 Winn Park Apt A, Woburn, MA 01801-3061

Other providers in Brockton