DOUGLAS NORMAN DEDERICH

GLENDALE, WI
NPI1932949203
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223P0300X Dentist, Periodontics
(Licence: WI  3322-15)
Enumeration Date2024-05-25
Last Update Date2024-05-25
Business Address
DOUGLAS NORMAN DEDERICH DDS, PhD
500 W SILVER SPRING DR STE K250
GLENDALE, WI 53217-5062
Phone number: 414-963-2301
Mailing Address
DOUGLAS NORMAN DEDERICH DDS, PhD
6330 W GREENFIELD AVE APT 408
MILWAUKEE, WI 53214-5073
Phone number: 780-868-1562