Provider Demographics
NPI:1003898008
Name:LORENTE, CAROL ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:LORENTE
Suffix:
Gender:F
Credentials:DMD
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Other - Credentials:
Mailing Address - Street 1:BEDFORD VA HOSPITAL
Mailing Address - Street 2:DENTAL DEPT., MAILSTOP 160, 200 SPRINGS RD.
Mailing Address - City:BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01730
Mailing Address - Country:US
Mailing Address - Phone:781-687-2469
Mailing Address - Fax:781-687-3967
Practice Address - Street 1:BEDFORD VA HOSPITAL
Practice Address - Street 2:DENTAL DEPT., MAILSTOP 160, 200 SPRINGS RD.
Practice Address - City:BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:01730
Practice Address - Country:US
Practice Address - Phone:781-687-2469
Practice Address - Fax:781-687-3967
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA14505204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
X04567OtherBCBS
794892OtherTUFTS
U12206Medicare UPIN
X04567OtherBCBS