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Organization
JEFFREY C. DERICKSON, D.D.S. PLLC
Active
Organization
JEFFREY C. DERICKSON, D.D.S. PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY CLINE DERICKSON D.D.S. (OWNER)
(520) 327-5993
Entity
Organization
Contact information
Practice address
762 N COUNTRY CLUB RD, TUCSON, AZ 85716-4535
(520) 327-5993
(520) 327-0907
Mailing address
762 N COUNTRY CLUB RD, TUCSON, AZ 85716-4535
(520) 327-5993
(520) 327-0907
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
2369
AZ
Other
Enumeration date
07/03/2007
Last updated
07/26/2012
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