Provider Demographics
NPI:1356536684
Name:LEMBO, DOMINICK ANTHONY (DMD)
Entity type:Individual
Prefix:DR
First Name:DOMINICK
Middle Name:ANTHONY
Last Name:LEMBO
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 1:476 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:HALEDON
Mailing Address - State:NJ
Mailing Address - Zip Code:07508-1744
Mailing Address - Country:US
Mailing Address - Phone:973-790-4494
Mailing Address - Fax:973-790-3765
Practice Address - Street 1:476 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:HALEDON
Practice Address - State:NJ
Practice Address - Zip Code:07508-1744
Practice Address - Country:US
Practice Address - Phone:973-790-4494
Practice Address - Fax:973-790-3765
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-10
Last Update Date:2007-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice