Provider Demographics
NPI:1124190350
Name:DARRYL R VEIT DDS, SC
Entity type:Organization
Organization Name:DARRYL R VEIT DDS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECT OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARRYL
Authorized Official - Middle Name:R
Authorized Official - Last Name:VEIT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:608-846-3302
Mailing Address - Street 1:502 NELSON CT
Mailing Address - Street 2:
Mailing Address - City:DE FOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-1267
Mailing Address - Country:US
Mailing Address - Phone:608-846-3302
Mailing Address - Fax:608-846-2354
Practice Address - Street 1:502 NELSON CT
Practice Address - Street 2:
Practice Address - City:DE FOREST
Practice Address - State:WI
Practice Address - Zip Code:53532-1267
Practice Address - Country:US
Practice Address - Phone:608-846-3302
Practice Address - Fax:608-846-2354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5001859-0151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty