Provider Demographics
NPI:1821204298
Name:BUONOCORE, LOREN C (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOREN
Middle Name:C
Last Name:BUONOCORE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:340 E 34TH ST
Mailing Address - Street 2:APT 17F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-4978
Mailing Address - Country:US
Mailing Address - Phone:914-960-0486
Mailing Address - Fax:
Practice Address - Street 1:1075 CENTRAL PARK AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-3242
Practice Address - Country:US
Practice Address - Phone:914-722-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0507381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry