Provider Demographics
NPI:1225076995
Name:LENT, DALE R (DO)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:R
Last Name:LENT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:233 COLLEGE AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17603-3384
Mailing Address - Country:US
Mailing Address - Phone:717-291-8512
Mailing Address - Fax:717-291-8547
Practice Address - Street 1:233 COLLEGE AVE STE 302
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17603-3384
Practice Address - Country:US
Practice Address - Phone:717-291-8512
Practice Address - Fax:717-291-8547
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007842L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001740770Medicaid
F79705Medicare UPIN
PA019400Medicare ID - Type Unspecified