Provider Demographics
NPI:1104829167
Name:DORENTER, PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:DORENTER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:516 RIVER RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07646-1955
Mailing Address - Country:US
Mailing Address - Phone:201-261-4860
Mailing Address - Fax:201-261-4872
Practice Address - Street 1:516 RIVER RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07646-1955
Practice Address - Country:US
Practice Address - Phone:201-261-4860
Practice Address - Fax:201-261-4872
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD1009891122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist