Provider Demographics
NPI:1780636548
Name:DINARDO, JOSEPH LAWRENCE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:LAWRENCE
Last Name:DINARDO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W CENTER ST
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-4864
Mailing Address - Country:US
Mailing Address - Phone:860-646-0230
Mailing Address - Fax:860-645-0349
Practice Address - Street 1:200 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06040-4864
Practice Address - Country:US
Practice Address - Phone:860-646-0230
Practice Address - Fax:860-645-0349
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT50531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice