Individual provider · Type 1 NPI

Michael Anthony Derose

General Practice Dentistry · Pueblo, CO

NPI number 1033185871 Active

Practice location

1022 Liberty Ln
Pueblo, CO 81001-2039

Call (719) 545-5778 Map

Mailing address

415 N Grand Ave
Pueblo, CO 81003-3111

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XDEN-5133 (CO)
General Practice Dentistry 1223G0001X12010424A (IN)
General Practice Dentistry 1223G0001X5643 (OK)
General Practice Dentistry 1223G0001XDD2030 (NM)
General Practice Dentistry 1223G0001X60184 (KS)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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About NPI 1033185871

Michael Anthony Derose's National Provider Identifier is 1033185871, issued on Feb 23, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Pueblo, CO. The record was last updated on Jul 13, 2026.