Provider Demographics
NPI:1942957410
Name:DINO LIRIO DDS INC
Entity Type:Organization
Organization Name:DINO LIRIO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.E.O.
Authorized Official - Prefix:DR
Authorized Official - First Name:DINO
Authorized Official - Middle Name:
Authorized Official - Last Name:LIRIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-300-8086
Mailing Address - Street 1:1701 SANTA CLARA DR STE 100
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-2967
Mailing Address - Country:US
Mailing Address - Phone:916-670-1006
Mailing Address - Fax:916-671-1516
Practice Address - Street 1:1701 SANTA CLARA DR STE 100
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2967
Practice Address - Country:US
Practice Address - Phone:916-670-1006
Practice Address - Fax:916-671-1516
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-04
Last Update Date:2022-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental