Individual
DEAN DELASANTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1431 N 8TH ST, SHEBOYGAN, WI 53081-3441
(920) 458-4142
Mailing address
1431 N 8TH ST, SHEBOYGAN, WI 53081-3441
(920) 458-4142
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5103
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33769500
—
WI
Enumeration date
01/12/2007
Last updated
07/08/2007
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