Healthcare Provider Details

I. General information

NPI: 1144377722
Provider Name (Legal Business Name): ROBERT LORINO D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

689 VALLEY RD SUITE 208
GILLETTE NJ
07933-1906
US

IV. Provider business mailing address

689 VALLEY RD SUITE 208
GILLETTE NJ
07933-1906
US

V. Phone/Fax

Practice location:
  • Phone: 908-542-0042
  • Fax: 908-542-0041
Mailing address:
  • Phone: 908-542-0042
  • Fax: 908-542-0041

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02152600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: