Provider Demographics
NPI:1841681624
Name:FAMILY DENTISTRY BY DR. MARIA M RINCON-LORENZO DDS LLC
Entity type:Organization
Organization Name:FAMILY DENTISTRY BY DR. MARIA M RINCON-LORENZO DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:RINCON-LORENZO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-438-5100
Mailing Address - Street 1:15 AMES AVE
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-1701
Mailing Address - Country:US
Mailing Address - Phone:201-438-5100
Mailing Address - Fax:
Practice Address - Street 1:15 AMES AVE
Practice Address - Street 2:
Practice Address - City:RUTHERFORD
Practice Address - State:NJ
Practice Address - Zip Code:07070-1701
Practice Address - Country:US
Practice Address - Phone:201-438-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-14
Last Update Date:2015-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01893200122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty