Derenzo, George T
Derenzo, George T is an sole proprietor health care provider with primary practice located at 4201 Miller Rd , Wilmington DE 19802-1914. He recently has 2 registered licenses in different health care specialties including Dental Providers / Orthodontics and Dentofacial Orthopedics, Dental Providers / Pediatric Dentistry. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Derenzo, George T can be contacted via phone (302) 354-6699.Contact Information
Primary practice address
4201 Miller Rd
Wilmington DE 19802-1914
Phone: (302) 354-6699
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | G1-0001106 | Delaware |
Dental Providers / Pediatric Dentistry | 1223P0221X | G1-0001106 | Delaware |
Profile Details
NPI number | 1811047962 |
---|---|
LBN Legal business name | Derenzo, George T |
Credentials | Doctor of Dental Surgery (DDS) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 11th, 2007 |
Last updated | Apr 25th, 2024 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1811047962 | NPPES |
Delaware | MEDICAID | 0001060631 |
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