Provider Demographics
NPI:1093876385
Name:LORENZI, IRMA MICHELLE (DMD)
Entity Type:Individual
Prefix:
First Name:IRMA
Middle Name:MICHELLE
Last Name:LORENZI
Suffix:
Gender:F
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:CLINICA LAS AMERICAS SUITE 505
Mailing Address - Street 2:AVE ROOSEVELT #400
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00918
Mailing Address - Country:US
Mailing Address - Phone:787-250-5055
Mailing Address - Fax:787-250-0511
Practice Address - Street 1:400 AVE FD ROOSEVELT
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:PR
Practice Address - Zip Code:00918-2103
Practice Address - Country:US
Practice Address - Phone:787-250-5055
Practice Address - Fax:787-250-0511
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2316122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist