Joseph Richard Deatherage, DMD, MD
NPI #1003859117 in Bismarck, North Dakota
Provider Information
- NPI Number
- 1003859117
- Entity Type
- Individual
- Name
- Joseph Richard Deatherage, DMD, MD
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Dentist - Oral and Maxillofacial Surgery
- Credential
- DMD, MD
- Enumeration Date
- Jun 14, 2006
- Last Updated
- May 1, 2019
Practice Location
- Address
- 1730 BURNT BOAT DR STE 300
- City
- Bismarck
- State
- North Dakota
- ZIP Code
- 58503-0886
- Phone
- (701) 258-7220
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery |
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