Individual
DEREK WALROD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1225 SOUTH POPLAR, SUITE 500, NORTH PLATTE, NE 69101
(308) 534-8080
Mailing address
1225 S POPLAR ST, SUITE 500, NORTH PLATTE, NE 69101-7785
(308) 534-8080
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6052
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47064373600
—
NE
Enumeration date
08/20/2009
Last updated
08/20/2009
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