DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: MICHAEL ANTHONY DEROSE

MEDICARE: MICHAEL ANTHONY DEROSE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice DentistryDEN-5133CO
21223G0001XGeneral Practice Dentistry12010424AIN
31223G0001XGeneral Practice Dentistry5643OK
41223G0001XGeneral Practice DentistryDD2030NM
51223G0001XGeneral Practice Dentistry60184KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033185871
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL ANTHONY DEROSE
Provider Business Mailing Address
First Line : 415 N GRAND AVE
Second Line :
City : PUEBLO
State : CO
Zip : 81003-3111
Country : US
Telephone Number : 719-546-3333
Fax Number :
Provider Business Practice Location Address
First Line : 1022 LIBERTY LN
Second Line :
City : PUEBLO
State : CO
Zip : 81001-2039
Country : US
Telephone Number : 719-545-5778
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/23/2006
Last Update Date : 07/09/2007

Similar Medicare Providers

1881671436 — ADOLPH RALPH PADULA DDS
Practice Location Address:
1022 LIBERTY LN
PUEBLO, CO
81001-2039
Practice Phone: 719-545-5778
Practice Fax: 719-545-5783
1699724831 — DEROSE CHILDREN'S DENTAL CLINIC, PC
Practice Location Address:
1022 LIBERTY LN
PUEBLO, CO
81001-2039
Practice Phone: 719-545-5775
Practice Fax:
1922304237 — DR. KUNJAN KAKAR DDS
Practice Location Address:
1022 LIBERTY LN
PUEBLO, CO
81001-2039
Practice Phone: 719-545-5778
Practice Fax:
1578822375 — FAMILY & KIDS DENTAL PC
Practice Location Address:
1022 LIBERTY LN
PUEBLO, CO
81001-2039
Practice Phone: 719-545-5778
Practice Fax:
1497163075 — SONIA EL-KWEIFI
Practice Location Address:
1022 LIBERTY LN
PUEBLO, CO
81001-2039
Practice Phone: 719-621-9682
Practice Fax:
1447633953 — BRACES4KIDS, PLLC
Practice Location Address:
1022 LIBERTY LN
PUEBLO, CO
81001-2039
Practice Phone: 970-523-6333
Practice Fax:

Directions to “ MICHAEL ANTHONY DEROSE ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.