MRS. Deiadre A Dery

NPI #1548610702 in Fort Knox, Kentucky

Provider Information

NPI Number: 1548610702
Entity Type: Individual
Name: MRS. Deiadre A Dery
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Assistant
Enumeration Date: Jun 20, 2016
Last Updated: Jun 20, 2016

Practice Location

Address: 962 1ST INFATRY DIVISION RD
Address 2: JORDAN DENTAL CLINIC BLDG 2724
City: Fort Knox
State: Kentucky
ZIP Code: 40121-5210
Phone: (502) 626-8301

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Assistant	126800000X	Primary

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