BRENT D DERAGISCH, DDS

NPI: 1164643292 · Individual · Active

Primary Specialty

Dentist

Practice Location

1500 NORTHWAY DRIVE
ST CLOUD, MN 56303 Map ↗
Phone: 320-253-7700
Fax: 320-253-9271

All Specialties & Licenses

  • Dentist Primary (license: 11953, MN)

NPI Registration

Enumerated: 2007-05-02

Last CMS Update: 2007-07-08