Individual
THERESA DICKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
880 HERRIOT DR, MAUSTON, WI 53948-2031
(608) 847-6700
(608) 847-6122
Mailing address
PO BOX 1440, WAUTOMA, WI 54982-1440
(920) 787-5514
(920) 787-4737
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
4477-16
WI
Other
Enumeration date
12/07/2018
Last updated
12/07/2018
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