Individual
DR. PAUL DOUGLAS DEITRICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
6200 MAIN ST, VOORHEES, NJ 08043-4629
(856) 325-6717
Mailing address
1 FEDERAL ST # 200, CAMDEN, NJ 08103-1088
(856) 356-4924
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
22DI02798900
NJ
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS037281
PA
Other
Enumeration date
06/08/2009
Last updated
03/24/2021
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