Herrick, Debora Ann
Herrick, Debora Ann is an individual health care provider with primary practice located at W315 N7641 Hywy 83 Po87 , North Lake WI 53064-0087. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Herrick, Debora Ann can be contacted via phone (262) 966-7668.Contact Information
Primary practice address
W315 N7641 Hywy 83 Po87
North Lake WI 53064-0087
Phone: (262) 966-7668
Fax: (262) 966-3420
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 003206 | Wisconsin |
| Dental Providers / General Practice | 1223G0001X | 6466 | Arizona |
| Dental Providers / General Practice | 1223G0001X | 1168 | Alaska |
Profile Details
| NPI number | 1336360973 |
|---|---|
| LBN Legal business name | Herrick, Debora Ann |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2007 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336360973 | NPPES |
| Wisconsin | Other | 33800000 | BADGERCARE |
| Wisconsin | MEDICAID | 33800000 | BADGERCARE |
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