Michael Anthony Derose

NPI #1033185871 in Pueblo, Colorado

Provider Information

NPI Number
1033185871
Entity Type
Individual
Name
Michael Anthony Derose
Gender
Not Specified
Sole Proprietor
Not Answered
Primary Specialty
Dentist - General Practice
Enumeration Date
Feb 23, 2006
Last Updated
Jul 9, 2007

Practice Location

Address
1022 LIBERTY LN
City
Pueblo
ZIP Code
81001-2039
Phone
(719) 545-5778

Specialties & Taxonomy Codes

Specialty
Dentist - General PracticeGeneral Practice

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