Individual
DR. PAUL HERBERT DERNEHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
211 N BROADWAY, SUITE 212, GREEN BAY, WI 54303-2757
(920) 435-3038
Mailing address
211 N BROADWAY, SUITE 212, GREEN BAY, WI 54303-2757
(920) 435-3038
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2265
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33392800
—
WI
Enumeration date
12/04/2006
Last updated
07/09/2007
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