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General NPI Number Information
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NPI Number | 1114415726
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Entity Type | Organization
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Legal Business Name | KEARNY ORTHODONTICS LLC
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Dates
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Enumeration Date | 04/30/2018
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 487 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-2734
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Country | US
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Telephone | 201-991-1253
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Fax |
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Provider Business Mailing Address
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Address Line | 487 KEARNY AVE
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City | KEARNY
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State | NJ
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Zip | 07032-2734
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Country | US
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Telephone | 201-991-1253
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT LORINO
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Credential | DMD
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Telephone | 973-342-1233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 22DI02152600
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License Number State | NJ
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