Derossi, Scott S

Derossi, Scott S is an individual health care provider with primary practice located at 1430 John Wesley Gilbert Drive, Gc-1024 Ghsu College Of Dental Medicine, Augusta GA 30912-1001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery, which is considered as his primary health care specialty. Derossi, Scott S can be contacted via phone (706) 721-9633.

Contact Information

Primary practice address
1430 John Wesley Gilbert Drive, Gc-1024 Ghsu College Of Dental Medicine Augusta GA 30912-1001
Phone: (706) 721-9633
Fax: (706) 723-0266
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X DS029512L Pennsylvania

Profile Details

NPI number 1184667370
LBN Legal business name Derossi, Scott S
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Nov 30th, 2012 - about 12 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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Identifiers

StateTypeNumberIssuer
All States NPI 1184667370 NPPES
Pennsylvania MEDICAID 0016969200001

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