Organization · Type 2 NPI
Jeffrey C. Derickson, D.d.s. PLLC
Dental Clinic/Center · Tucson, AZ
NPI number
1154529006
Active
Practice location
762 N Country Club Rd
Tucson, AZ 85716-4535
Fax (520) 327-0907
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dental Clinic/Center Primary | 261QD0000X | 2369 (AZ) |
Dental Clinic/Center: Definition to come...
3 other providers at this address
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About NPI 1154529006
Jeffrey C. Derickson, D.d.s. PLLC's National Provider Identifier is 1154529006, issued on Jul 3, 2007. The primary taxonomy on file is Dental Clinic/Center (261QD0000X), and the practice location is in Tucson, AZ. The record was last updated on Jul 26, 2012.