Provider Demographics
NPI:1528197498
Name:DRS. RONALD AND CHRISTOPHER DILEO
Entity Type:Organization
Organization Name:DRS. RONALD AND CHRISTOPHER DILEO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:FONTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-821-0422
Mailing Address - Street 1:4104 W TILGHMAN ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-4428
Mailing Address - Country:US
Mailing Address - Phone:610-821-0422
Mailing Address - Fax:610-821-9018
Practice Address - Street 1:4104 W TILGHMAN ST
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-4428
Practice Address - Country:US
Practice Address - Phone:610-821-0422
Practice Address - Fax:610-821-9018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS014226L1223S0112X
PADS027267L1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA114028Medicare ID - Type UnspecifiedCHRISTOPHER T. DILEO DMD
PAT71627Medicare UPIN
PAU37521Medicare UPIN
PA061469Medicare ID - Type UnspecifiedRONALD C. DILEO, DDS