Individual
DR. ANTHONY CHARLES DERRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2633 W STATE ROAD 434, LONGWOOD, FL 32779-4878
(407) 788-8400
(407) 682-4659
Mailing address
2633 W STATE ROAD 434, LONGWOOD, FL 32779-4878
(407) 788-8400
(407) 682-4659
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0005472
FL
Other
Enumeration date
06/06/2006
Last updated
04/09/2009
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