JAMES L. DERRICO DDS LLC

JACKSON, WY
NPI1235700014
Entity TypeOrganization
Authorized ContactJAMES L DERRICO
Owner
630-399-7367
Organization Subpart ?No
Primary Taxonomy332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment
Additional Taxonomies261QD0000X Clinic/Center, Dental
Enumeration Date2021-07-02
Last Update Date2023-08-03
Business Address
JAMES L. DERRICO DDS LLC
1130 S HWY 89
JACKSON, WY 83001-8512
Phone number: 307-200-6644
Mailing Address
JAMES L. DERRICO DDS LLC
PO BOX 806
JACKSON, WY 83001-0806
Phone number: 630-399-7367