Derisse, Debbie Kethelyn

Derisse, Debbie Kethelyn is an sole proprietor health care provider with primary practice located at 1070 Saint James Ave , Springfield MA 01104-1453. She recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Pediatric Dentistry. Dental Providers / Pediatric Dentistry is her primary health care specialty. Derisse, Debbie Kethelyn can be contacted via phone (917) 667-7876.

Contact Information

Primary practice address
1070 Saint James Ave Springfield MA 01104-1453
Phone: (917) 667-7876
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 22DI 02433600 New Jersey
Dental Providers / Pediatric Dentistry 1223P0221X DN1856361 Massachusetts

Profile Details

NPI number 1841501723
LBN Legal business name Derisse, Debbie Kethelyn
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 25th, 2010
Last updated Jun 23rd, 2014 - about 11 years ago

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.

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