Rick Jerome Deroven, DDS

NPI #1982627105 in Walled Lake, Michigan

Provider Information

NPI Number: 1982627105
Entity Type: Individual
Name: Rick Jerome Deroven, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jul 26, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 2340 S COMMERCE RD
Address 2: STE 1
City: Walled Lake
State: Michigan
ZIP Code: 48390-2126
Phone: (248) 624-0676

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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