Derick Sovereign, DMD

NPI 1245073287 · on the registry since 2024 · sole proprietor

Practice

Address: 3765 E Blue Lupine Dr Ste A
Wasilla, AK 99654
Phone: (480) 341-0791
Organisation at this address: Lupine Dental Llc
Valley Upright Imaging Llc
Pioneer Peak Orthopedics Llc
Empower Physical Therapy, Llc
Empower Physical Therapy Limited Partnership
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 30

Registry record

Primary taxonomy: Dentist
122300000X
Licence states on file: AK
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-06-17

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Alaska