Individual
DR. DANIEL JORDAN BERQUIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1444 119TH ST, WHITING, IN 46394-1760
(219) 659-1530
(219) 659-1532
Mailing address
1444 119TH ST, WHITING, IN 46394-1760
(219) 659-1530
(219) 659-1532
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12012019A
IN
Other
Enumeration date
08/12/2013
Last updated
08/12/2013
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