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Dr. Nicolet Derose, DDS
Pediatric Dentist in Racine, Wisconsin
NPI 1194892166

Nicolet Derose is a Pediatric Dentist based in Racine, WI and is specialized in Pediatric Dentistry. Nicolet Derose practices in Racine, WI and has the professional credentials of DDS. The NPI Number for Nicolet Derose is 1194892166 and holds a License No. 2362 (Wisconsin).

The current practice location address for Nicolet Derose is 316 5Th St, Racine, WI and can be reached out via phone at 262-534-8662.

Location: 316 5Th St, Racine, WI, 53403-4606
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1194892166
Provider Name
Nicolet Derose
Credential
DDS
Provider Entity Type
Individual
Gender
Female
Address
316 5Th St, Racine, WI, 53403-4606
Phone Number
262-534-8662
Fax Number
Provider Enumeration Date
11/29/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
316 5Th St
City
Racine
State
Wisconsin
Zip
53403-4606
Phone Number
262-534-8662
Fax Number
person
Provider Business Mailing Address Details
Address
316 5Th St
City
Racine
State
Wisconsin
Zip
53403-4606
Phone Number
262-534-8662
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
2362 (Wisconsin)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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