Individual
DAVID M DETTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
804 ILLINOIS STREET, SIDNEY, IA 51652
(712) 374-2029
Mailing address
107 N 10TH ST, NEBRASKA CITY, NE 68410-2329
(402) 873-5040
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5136
NE
1223G0001X
General Practice Dentistry
Primary
6865
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0091421
—
IA
05
—
470681388001
—
NE
Enumeration date
11/30/2006
Last updated
07/09/2007
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