Jeremy Derksen, DDS

NPI #1740573443 in Roseville, Minnesota

Provider Information

NPI Number: 1740573443
Entity Type: Individual
Name: Jeremy Derksen, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: May 27, 2011
Last Updated: May 27, 2011

Practice Location

Address: 185 MCCARRONS BLVD N #316
City: Roseville
State: Minnesota
ZIP Code: 55113
Phone: (515) 326-5977

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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