Provider Demographics
NPI:1366558363
Name:MATTHEW C. LOCHETTO, DMD, PC
Entity type:Organization
Organization Name:MATTHEW C. LOCHETTO, DMD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:C
Authorized Official - Last Name:LOCHETTO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:609-275-1175
Mailing Address - Street 1:196 PRINCETON HIGHTSTOWN RD
Mailing Address - Street 2:BUILDING 2A, SUITE 3
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1672
Mailing Address - Country:US
Mailing Address - Phone:609-275-1175
Mailing Address - Fax:609-275-1197
Practice Address - Street 1:196 PRINCETON HIGHTSTOWN RD
Practice Address - Street 2:BUILDING 2A, SUITE 3
Practice Address - City:WEST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08550-1672
Practice Address - Country:US
Practice Address - Phone:609-275-1175
Practice Address - Fax:609-275-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-22
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019804001223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty