Provider Demographics
NPI:1619136199
Name:E. PAUL DELORME DMD, PLC
Entity Type:Organization
Organization Name:E. PAUL DELORME DMD, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:DELORME
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:520-881-0714
Mailing Address - Street 1:1575 N SWAN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-4071
Mailing Address - Country:US
Mailing Address - Phone:520-881-0714
Mailing Address - Fax:
Practice Address - Street 1:1575 N SWAN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-4071
Practice Address - Country:US
Practice Address - Phone:520-881-0714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty