Individual
DR. DERGHAM DERGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4785 LEAVITT RD, LORAIN, OH 44053-2136
(440) 282-6677
Mailing address
4785 LEAVITT ROAD, LORAIN, OH 44053
(440) 282-6677
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30-023579
OH
Other
Enumeration date
11/14/2011
Last updated
11/14/2011
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