Provider Demographics
NPI:1194043281
Name:DILORENZO, CHRISTOPHER MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:MATTHEW
Last Name:DILORENZO
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:P.O. BOX 908
Mailing Address - Street 2:INDIAN HEAD HWY.
Mailing Address - City:BRAYNS ROAD
Mailing Address - State:MD
Mailing Address - Zip Code:20616
Mailing Address - Country:US
Mailing Address - Phone:301-283-4424
Mailing Address - Fax:
Practice Address - Street 1:6845
Practice Address - Street 2:INDIAN HEAD HWY.
Practice Address - City:BRYANS ROAD
Practice Address - State:MD
Practice Address - Zip Code:20616
Practice Address - Country:US
Practice Address - Phone:301-283-4424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2010-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13833122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist