Individual
DR. PAUL DOUGLAS DEITRICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
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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