Justin Thomas Derk, DMD
Student in an Organized Health Care Education/Training Program in Danville, PA. Individual provider (NPI-1).
NPI number1619811916
StatusActive
Last updated in NPPESApr 16, 2026
Details
- NPI
- 1619811916
- Entity type
- Individual (NPI-1)
- Name
- Justin Thomas Derk
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 16, 2026
- Certification date
- Apr 16, 2026
- Last updated
- Apr 16, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | PA | Yes |
Practice location
20 Wesner LnDanville, PA 17821-8023
Phone 570-275-6617
Mailing address
142 Butternut LnElysburg, PA 17824-7206
Other practice locations
2 Utah Dr
Kulpmont, PA 17834-1972
Kulpmont, PA 17834-1972
Phone 570-373-5563
112 Ironstone Dr Ste B
Northumberland, PA 17857-8543
Northumberland, PA 17857-8543
Phone 570-235-2468
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All 358 Student in an Organized Health Care Education/Training Program providers in Danville · All 3,282 providers in Danville
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