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Dr. Jordan Dietrich, DDS
General Practice Dentistry in Waupaca, Wisconsin
NPI 1902582604

Jordan Dietrich is a General Practice Dentistry based in West Bend, WI and is specialized in General Practice. Jordan Dietrich practices in Waupaca, WI and has the professional credentials of DDS. The NPI Number for Jordan Dietrich is 1902582604 and holds a License No. 6001224-15 (Wisconsin).

The current practice location address for Jordan Dietrich is 825 W Fulton St, Waupaca, WI and can be reached out via phone at 920-731-7445.

Location: 825 W Fulton St, Waupaca, WI, 53095-9196
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1902582604
Provider Name
Jordan Dietrich
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
825 W Fulton St, Waupaca, WI, 53095-9196
Phone Number
920-731-7445
Fax Number
Provider Enumeration Date
06/26/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
825 W Fulton St
City
Waupaca
State
Wisconsin
Zip
54981-1471
Phone Number
920-731-7445
Fax Number
person
Provider Business Mailing Address Details
Address
825 W Fulton St
City
Waupaca
State
Wisconsin
Zip
54981-1471
Phone Number
920-731-7445
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
6001224-15 (Wisconsin)
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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