Individual
GARY L DENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
620 W BROWN ST, WAUPUN, WI 53963-1702
(920) 926-8332
(920) 926-8370
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
84878
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
43303300
—
WI
Enumeration date
11/01/2006
Last updated
11/12/2014
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