Individual
DR. GAY M DERDERIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1801 WEST WISCONSIN AVE, MILWAUKEE, WI 53233
(414) 288-0788
(414) 288-0678
Mailing address
PO BOX 1881, MILWAUKEE, WI 53201-1881
(414) 288-0788
(414) 288-0678
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
3370015
WI
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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