Organization
RICK J DEROVEN DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK J DEROVEN DDS (OWNER)
(248) 624-0676
Entity
Organization
Contact information
Practice address
2340 S COMMERCE RD, WALLED LAKE, MI 48390-2174
(248) 624-0676
Mailing address
2340 S COMMERCE RD, WALLED LAKE, MI 48390-2174
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
02/17/2021
Last updated
02/17/2021
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