James L Derrico, DDS, LLC

NPI #1891801585 in Jackson, Wyoming

Provider Information

NPI Number: 1891801585
Entity Type: Individual
Name: James L Derrico, DDS, LLC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS, LLC
Enumeration Date: Aug 22, 2006
Last Updated: May 7, 2023

Practice Location

Address: 1130 S HWY 89
City: Jackson
State: Wyoming
ZIP Code: 83001-8512
Phone: (307) 200-6644

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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