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Individual

JEFFREY STEVEN WITHUSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
103 9TH ST N, WAHPETON, ND 58075-4311
(701) 642-8566
(701) 642-1111
Mailing address
7747 MARIE ST, WAHPETON, ND 58075-9628
(701) 642-2129
(701) 642-1111

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1807
ND

Other

Enumeration date
08/20/2006
Last updated
07/08/2007
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