Individual
DR. ROBERT ANTHONY DERICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
9 SANBORN ST, PORTLAND, ME 04103-2107
(207) 878-3100
(207) 878-6120
Mailing address
9 SANBORN ST, PORTLAND, ME 04103-2107
(207) 878-3100
(207) 878-6120
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2652
ME
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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