Provider Demographics
NPI:1346541604
Name:DIMONTE, GLORIA BERTA (DDS)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:BERTA
Last Name:DIMONTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CORPORATE DRIVE EAST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-579-2558
Mailing Address - Fax:
Practice Address - Street 1:109 CORPORATE DR E
Practice Address - Street 2:SUITE 109
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-8005
Practice Address - Country:US
Practice Address - Phone:215-579-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS25416-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice