Provider Demographics
NPI:1437450087
Name:DILORENZO, VINCENT PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:PETER
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 1:2401 PENNSYLVANIA AVE
Mailing Address - Street 2:UNIT # 20-B27
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3010
Mailing Address - Country:US
Mailing Address - Phone:215-763-5369
Mailing Address - Fax:800-430-8849
Practice Address - Street 1:2401 PENNSYLVANIA AVE
Practice Address - Street 2:UNIT # 20-B27
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3010
Practice Address - Country:US
Practice Address - Phone:215-763-5369
Practice Address - Fax:800-430-8849
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-14
Last Update Date:2010-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS019892L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice