Nobrega, Derek
Nobrega, Derek is an sole proprietor health care provider with primary practice located at 21 Peace St , Providence RI 02907-1510. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Nobrega, Derek can be contacted via phone (401) 456-4461.Contact Information
Primary practice address
21 Peace St
Providence RI 02907-1510
Phone: (401) 456-4461
Fax: (401) 456-4420
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | LD00081 | Rhode Island |
Profile Details
| NPI number | 1871858233 |
|---|---|
| LBN Legal business name | Nobrega, Derek |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 11th, 2012 |
| Last updated | Jul 11th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871858233 | NPPES |
| Rhode Island | Other | LD00081 | LICENSE |
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