Provider Demographics
NPI:1528217080
Name:DILORETO, DAVID GEORGE (DDS)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:GEORGE
Last Name:DILORETO
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 1:20690 VERNIER RD
Mailing Address - Street 2:
Mailing Address - City:HARPER WOODS
Mailing Address - State:MI
Mailing Address - Zip Code:48225-1415
Mailing Address - Country:US
Mailing Address - Phone:313-884-3050
Mailing Address - Fax:313-884-0007
Practice Address - Street 1:20690 VERNIER RD
Practice Address - Street 2:
Practice Address - City:HARPER WOODS
Practice Address - State:MI
Practice Address - Zip Code:48225-1415
Practice Address - Country:US
Practice Address - Phone:313-884-3050
Practice Address - Fax:313-884-0007
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010131351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice