Provider Demographics
NPI:1033350533
Name:PADOVANO, SUZANNE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:
Last Name:PADOVANO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:SUZANNE
Other - Middle Name:
Other - Last Name:LORINO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:286 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2427
Mailing Address - Country:US
Mailing Address - Phone:973-635-2328
Mailing Address - Fax:
Practice Address - Street 1:286 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2427
Practice Address - Country:US
Practice Address - Phone:973-635-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-12
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102267000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist