Provider Demographics
NPI:1598800658
Name:DILORENZO, HENRY (DDS)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:
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:PO BOX 2768
Mailing Address - Street 2:
Mailing Address - City:LA PLATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-2768
Mailing Address - Country:US
Mailing Address - Phone:301-870-3989
Mailing Address - Fax:301-870-3608
Practice Address - Street 1:113 LAGRANGE AVENUE
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-2768
Practice Address - Country:US
Practice Address - Phone:301-870-3989
Practice Address - Fax:301-870-3608
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD53391223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics