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General NPI Number Information
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NPI Number | 1568203396
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Entity Type | Organization
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Legal Business Name | MARC DELORENZO DMD LLC
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Dates
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Enumeration Date | 06/05/2024
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 401 GILFORD AVE STE 245
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City | GILFORD
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State | NH
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Zip | 03249-7526
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Country | US
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Telephone | 603-524-7677
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Fax |
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Provider Business Mailing Address
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Address Line | 401 GILFORD AVE STE 245
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City | GILFORD
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State | NH
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Zip | 03249-7526
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Country | US
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Telephone | 603-524-7677
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Fax |
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | DR. MARC HENRY DELORENZO
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Credential | DMD
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Telephone | 334-332-6921
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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