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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