Provider Demographics
NPI:1861774374
Name:TRUSCHINGER, DEEDRA A (DDS)
Entity type:Individual
Prefix:DR
First Name:DEEDRA
Middle Name:A
Last Name:TRUSCHINGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:DEEDRA
Other - Middle Name:A
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:930 N WASHINGTON
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:KS
Mailing Address - Zip Code:66402
Mailing Address - Country:US
Mailing Address - Phone:785-256-2489
Mailing Address - Fax:
Practice Address - Street 1:930 N WASHINGTON
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:KS
Practice Address - Zip Code:66402
Practice Address - Country:US
Practice Address - Phone:785-256-2489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-12
Last Update Date:2019-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS608021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice