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1932949203
DOUGLAS NORMAN DEDERICH
GLENDALE, WI
NPI
1932949203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223P0300X Dentist, Periodontics
(Licence: WI 3322-15)
Enumeration Date
2024-05-25
Last Update Date
2024-05-25
Business Address
DOUGLAS NORMAN DEDERICH DDS, PhD
500 W SILVER SPRING DR STE K250
GLENDALE, WI 53217-5062
Phone number: 414-963-2301
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Mailing Address
DOUGLAS NORMAN DEDERICH DDS, PhD
6330 W GREENFIELD AVE APT 408
MILWAUKEE, WI 53214-5073
Phone number: 780-868-1562
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