National Provider Identifier

Joseph Anthony Derose, D.D.S.

Joseph Anthony Derose, D.D.S. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Lackawanna, NY and a listed phone number of (716) 828-9334.

NPI 1538342928Lackawanna, NYGeneral Practice Dentistry

Profile Overview

NPI
1538342928
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
December 09, 2007
Last Updated
December 09, 2007

Practice Location

  • 790 Ridge RD
  • Lackawanna, NY 14218-1629

Phone: (716) 828-9334

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1538342928
Entity Type
Individual
Last Name
Derose
First Name
Joseph
Middle Name
Anthony
Name Prefix
Dr.
Credential
D.D.S.
Mailing Street Address
790 Ridge RD
Mailing City
Lackawanna
Mailing State
NY
Mailing ZIP Code
14218-1629
Mailing Country
US
Mailing Phone
(716) 828-9334
Practice Street Address
790 Ridge RD
Practice City
Lackawanna
Practice State
NY
Practice ZIP Code
14218-1629
Practice Country
US
Practice Phone
(716) 828-9334
Enumeration Date
December 09, 2007
Last Updated
December 09, 2007
Sex
Male
Sole Proprietor
No
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)