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1255889788
DEREK ROBERT BERQUIST
CROWN POINT, IN
NPI
1255889788
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IN 12012546A)
Enumeration Date
2016-09-13
Last Update Date
2016-09-13
Business Address
Dr. DEREK ROBERT BERQUIST DMD
11059 BROADWAY SUITE B
CROWN POINT, IN 46307-8834
Phone number: 219-226-0544
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Mailing Address
Dr. DEREK ROBERT BERQUIST DMD
9044 BUNKER HILL DR
MUNSTER, IN 46321-3203
Phone number: 219-765-7468
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