Provider Demographics
NPI:1073568929
Name:TREMBATH, LORI M (DDS)
Entity Type:Individual
Prefix:DR
First Name:LORI
Middle Name:M
Last Name:TREMBATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12774 COLORADO BLVD STE 171
Mailing Address - Street 2:11
Mailing Address - City:THORNTON
Mailing Address - State:CO
Mailing Address - Zip Code:80241-2887
Mailing Address - Country:US
Mailing Address - Phone:303-457-3046
Mailing Address - Fax:
Practice Address - Street 1:12774 COLORADO BLVD STE 171
Practice Address - Street 2:11
Practice Address - City:THORNTON
Practice Address - State:CO
Practice Address - Zip Code:80241-2887
Practice Address - Country:US
Practice Address - Phone:303-457-3046
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2016-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO89421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice