Provider Demographics
NPI:1073735627
Name:LORENTZEN, STEVEN HAROLD (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:HAROLD
Last Name:LORENTZEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 WAYZATA BLVD
Mailing Address - Street 2:#920
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1248
Mailing Address - Country:US
Mailing Address - Phone:763-540-0101
Mailing Address - Fax:
Practice Address - Street 1:5500 WAYZATA BLVD
Practice Address - Street 2:#920
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55416-1248
Practice Address - Country:US
Practice Address - Phone:763-540-0101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND91011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice