Provider Demographics
NPI:1023195732
Name:DELGIZZO, WILLIAM LORD (DMD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:LORD
Last Name:DELGIZZO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CHAPEL VIEW BOULEVARD, SUITE 200
Mailing Address - Street 2:CHAPEL VIEW FAMILY & COSMETIC DENTISTRY
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02920-3062
Mailing Address - Country:US
Mailing Address - Phone:401-944-8103
Mailing Address - Fax:401-944-1854
Practice Address - Street 1:30 CHAPEL VIEW BOULEVARD, SUITE 200
Practice Address - Street 2:CHAPEL VIEW FAMILY & COSMETIC DENTISTRY
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02920-3062
Practice Address - Country:US
Practice Address - Phone:401-944-8103
Practice Address - Fax:401-944-1854
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2010-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI2153122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist