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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 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 1811047962 NPPES
Delaware MEDICAID 0001060631

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