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Individual
ALLYSON STEWART DKEIDEK
Active
Individual
ALLYSON STEWART DKEIDEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12011261A
IN
122300000X
Dentist
Primary
6197-15
WI
122300000X
Dentist
DE60124299
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2008604
—
WA
05
—
33386500
—
WI
05
—
33730800
—
WI
05
—
33794900
—
WI
Enumeration date
03/03/2008
Last updated
02/28/2012
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