Individual
DR. JASON PAUL VANDEHAAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6317 ODANA RD, MADISON, WI 53719-1107
(608) 274-1911
Mailing address
4726 WAUKESHA ST, MADISON, WI 53705-4843
(608) 239-2502
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6506-015
WI
Other
Enumeration date
06/02/2010
Last updated
04/23/2013
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