Organization
JAMES L DERRICO DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES L. DERRICO DDS (OWNER)
(630) 983-8700
Entity
Organization
Contact information
Practice address
6448 COLLEGE RD, LISLE, IL 60532-3290
(630) 983-8700
(630) 983-8512
Mailing address
6448 COLLEGE RD, LISLE, IL 60532-3290
(630) 983-8700
(630) 983-8512
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.019814
IL
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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