Individual
DR. DEREK DANNY WEIGAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
4302 13TH AVE S STE 10, FARGO, ND 58103-3395
(701) 281-8000
Mailing address
4302 13TH AVE S STE 10, FARGO, ND 58103-3395
(701) 281-8000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2396
ND
122300000X
Dentist
6034
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
473891686
473891686
—
Enumeration date
07/29/2013
Last updated
04/26/2021
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