Individual
DR. DEBORA ANN HERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
W315 N7641 HYWY 83 PO87, NORTH LAKE, WI 53064-0087
(262) 966-7668
(262) 966-3420
Mailing address
W315 N7641 HYWY 83, HARTLAND, WI 53029
(262) 966-7668
(262) 966-3420
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
003206
WI
1223G0001X
General Practice Dentistry
1168
AK
1223G0001X
General Practice Dentistry
6466
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33800000
BADGERCARE
WI
05
—
33800000
—
WI
Enumeration date
05/01/2007
Last updated
07/08/2007
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