Provider Demographics
NPI:1407902463
Name:LORINO, GERALD JOHN (DMD)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:JOHN
Last Name:LORINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2410
Mailing Address - Country:US
Mailing Address - Phone:973-635-2328
Mailing Address - Fax:973-701-1131
Practice Address - Street 1:287 MAIN ST
Practice Address - Street 2:
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2410
Practice Address - Country:US
Practice Address - Phone:973-635-2328
Practice Address - Fax:973-701-1131
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI021404001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice