Individual
DR. EVELYN KATRINA HAUSER-FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
137 E MAIN ST, GILLETT, WI 54124-9386
(920) 855-2155
(920) 855-2639
Mailing address
PO BOX 266, 137 E MAIN ST., GILLETT, WI 54124-0266
(920) 855-2155
(920) 855-2639
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5002024-015
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1356554851
NPI TYPE II
—
05
—
33374500
—
WI
01
—
5002024-015
STATE DENTAL LICENSE
WI
Enumeration date
06/17/2014
Last updated
06/17/2014
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