Provider Demographics
NPI:1437123163
Name:DIPIETRO, NANCY R (DDS)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:R
Last Name:DIPIETRO
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 1:2 ROLLING RD
Mailing Address - Street 2:
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3527
Mailing Address - Country:US
Mailing Address - Phone:610-896-6361
Mailing Address - Fax:610-896-6361
Practice Address - Street 1:2 ROLLING RD
Practice Address - Street 2:
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3527
Practice Address - Country:US
Practice Address - Phone:610-896-6361
Practice Address - Fax:610-896-6361
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-023649-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice