Provider Demographics
NPI:1023547676
Name:LENNARD, CALE DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:CALE
Middle Name:DAVID
Last Name:LENNARD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 9TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-4060
Mailing Address - Country:US
Mailing Address - Phone:940-322-4401
Mailing Address - Fax:940-766-2999
Practice Address - Street 1:2405 9TH ST STE A
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301
Practice Address - Country:US
Practice Address - Phone:940-322-4401
Practice Address - Fax:940-766-2999
Is Sole Proprietor?:No
Enumeration Date:2017-06-07
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX355141223G0001X
ORD107051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice