GREGORY DEROSE JR., DDS

Dentist

Active Individual
NPI: 1225601511

Practice Address

7223 MISSISSIPPI AVENUE
BLDG 1561
Fort Polk, LA 71459

Phone: (337) 531-2603

Specialties

Specialty Code Primary License
Dentist 122300000X Yes 4515 (AR)

Frequently Asked Questions

NPI 1225601511 is the National Provider Identifier for GREGORY DEROSE JR., DDS, a Dentist provider located in Fort Polk, LA. This NPI was enumerated on July 23, 2021.
GREGORY DEROSE JR., DDS practices at 7223 MISSISSIPPI AVENUE, BLDG 1561, Fort Polk, LA 71459.

Quick Facts

NPI
1225601511
Type
Individual
Enumerated
Jul 23, 2021
Last Updated
Jul 23, 2021

Nearby Providers