Individual
DEREK WILLIAM HIAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
513 MAIN ST, LISBON, ND 58054-4145
(701) 308-0151
Mailing address
PO BOX 44, LISBON, ND 58054-0044
(701) 308-0151
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2350
ND
Other
Enumeration date
08/03/2018
Last updated
08/03/2018
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