Individual
DR. GREGORY WILLIAMS DIEDRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
605 W DOUGLAS RD, MISHAWAKA, IN 46545-1438
(574) 277-2220
Mailing address
605 W DOUGLAS RD, MISHAWAKA, IN 46545-1438
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12012784A.
IN
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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