Provider Demographics
NPI:1972970911
Name:DELIO ORTHODONTICS INC.
Entity Type:Organization
Organization Name:DELIO ORTHODONTICS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAMIEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:DELIO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-377-6895
Mailing Address - Street 1:827 DEEP VALLEY DR
Mailing Address - Street 2:SUITE 302
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3647
Mailing Address - Country:US
Mailing Address - Phone:310-377-6895
Mailing Address - Fax:
Practice Address - Street 1:827 DEEP VALLEY DR
Practice Address - Street 2:SUITE 302
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3647
Practice Address - Country:US
Practice Address - Phone:310-377-6895
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA391431223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty