Individual
YVONNE R. DEJEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
806 W 5TH ST, MARSHFIELD, WI 54449-2614
(715) 387-1896
Mailing address
806 W 5TH ST, MARSHFIELD, WI 54449-2614
(715) 387-1896
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
2926
WI
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
2926
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
33475400
—
WI
Enumeration date
08/29/2006
Last updated
09/14/2011
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