Dejarlais, Daniel Jason

Dejarlais, Daniel Jason is an individual health care provider with primary practice located at 7001 Old Sauk Rd , Madison WI 53717-2308. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Dejarlais, Daniel Jason can be contacted via phone (608) 833-6545.

Contact Information

Primary practice address
7001 Old Sauk Rd Madison WI 53717-2308
Phone: (608) 833-6545
Fax: (608) 833-8516
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 5036-15 Wisconsin

Profile Details

NPI number 1669573895
LBN Legal business name Dejarlais, Daniel Jason
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669573895 NPPES
Wisconsin MEDICAID 33755100

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