National Provider Identifier
Jeffery A. Derose, DDS
Jeffery A. Derose, DDS is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Niagara Falls, NY and a listed phone number of (716) 298-3567.
Profile Overview
- NPI
- 1184885717
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- June 17, 2008
- Last Updated
- June 17, 2008
Practice Location
- 2145 Lancelot Dr
- Niagara Falls, NY 14304-3093
Phone: (716) 298-3567
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1184885717
- Entity Type
- Individual
- Last Name
- Derose
- First Name
- Jeffery
- Middle Name
- A.
- Name Prefix
- Dr.
- Credential
- DDS
- Mailing Street Address
- 2145 Lancelot Dr
- Mailing City
- Niagara Falls
- Mailing State
- NY
- Mailing ZIP Code
- 14304-3093
- Mailing Country
- US
- Mailing Phone
- (716) 298-3567
- Mailing Fax
- (716) 297-9855
- Practice Street Address
- 2145 Lancelot Dr
- Practice City
- Niagara Falls
- Practice State
- NY
- Practice ZIP Code
- 14304-3093
- Practice Country
- US
- Practice Phone
- (716) 298-3567
- Practice Fax
- (716) 297-9855
- Enumeration Date
- June 17, 2008
- Last Updated
- June 17, 2008
- Sex
- Male
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)
- Other Identifiers
- 02783017 (NY)