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Michael Anthony Derose
General Practice Dentistry in Pueblo, Colorado
NPI 1033185871

Michael Anthony Derose is a General Practice Dentistry based in Pueblo, CO and is specialized in General Practice. Michael Anthony Derose practices in Pueblo, CO. The NPI Number for Michael Anthony Derose is 1033185871 and holds a License No. DEN-5133 (Colorado).

The current practice location address for Michael Anthony Derose is 1022 Liberty Ln, Pueblo, CO and can be reached out via phone at 719-545-5778. You can also correspond with Michael Anthony Derose through the mailing address at 415 N GRAND AVE, PUEBLO, CO - 81003-3111 (mailing address contact number: 719-546-3333).

Location: 1022 Liberty Ln, Pueblo, CO, 81003-3111
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1033185871
Provider Name
Michael Anthony Derose
Credential
Provider Entity Type
Individual
Gender
Male
Address
1022 Liberty Ln, Pueblo, CO, 81003-3111
Phone Number
719-545-5778
Fax Number
Provider Enumeration Date
02/23/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2051332 05 CO
institution
Provider Business Practice Location Address Details
Address
1022 Liberty Ln
City
Pueblo
State
Colorado
Zip
81001-2039
Phone Number
719-545-5778
Fax Number
person
Provider Business Mailing Address Details
Address
415 N Grand Ave
City
Pueblo
State
Colorado
Zip
81003-3111
Phone Number
719-546-3333
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
DEN-5133 (Colorado)
Definition
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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