Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DOUGLAS NORMAN DEDERICH, DDS, PHD
Active Sole ProprietorDOUGLAS NORMAN DEDERICH, DDS, PHD is a Periodontology healthcare provider located in GLENDALE, Wisconsin. NPI 1932949203 is currently active in the NPPES registry. Verify at CMS.
Periodontology · GLENDALE, WI
Registration Details
- NPI Number
- 1932949203
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 25, 2024 (2.2422219504761 yrs)
- Last Updated
- May 25, 2024
- License
-
3322-15 (WI)
- Sole Proprietor
- Yes
Practice Information
- Address
-
500 W SILVER SPRING DR STE K250GLENDALE, WI, 532175062Browse WI providers · Browse ZIP 53217
- Phone
- 4149632301
- Primary Specialty
-
Periodontology
1223P0300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.