Provider Demographics
NPI:1194864389
Name:NYCE TOLLEY & LORENZO LLC
Entity Type:Organization
Organization Name:NYCE TOLLEY & LORENZO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:NYCE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:215-855-1088
Mailing Address - Street 1:1101 SOUTH BROAD ST
Mailing Address - Street 2:PO BOX 622
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5570
Mailing Address - Country:US
Mailing Address - Phone:215-855-1088
Mailing Address - Fax:215-855-5384
Practice Address - Street 1:1101 SOUTH BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5570
Practice Address - Country:US
Practice Address - Phone:215-855-1088
Practice Address - Fax:215-855-5384
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS015466L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
71915OtherUCCI