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Jordan Dietrich, DDS
NPI 1902582604 · on the registry since 2023
Practice
- Address
- 400 S Townline Rd
Wautoma, WI 54982 - Phone
- (920) 787-5514
- Organisation at this address
- La Clinica De Los Campesinos, Inc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 47
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- WI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-10-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Wisconsin