Individual
MICHAEL D DEROSA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
156 WOODROW AVE STE 2, SAINT CLAIRSVILLE, OH 43950-1181
(740) 695-5400
(740) 695-4998
Mailing address
156 WOODROW AVE STE 2, SAINT CLAIRSVILLE, OH 43950-1181
(740) 695-5400
(740) 695-4998
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
OH17645
OH
Other
Enumeration date
12/13/2006
Last updated
07/08/2007
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