Provider Demographics
NPI:1235784992
Name:E. JOSEPH LENZ DDS PC FAMILY DENTISTRY
Entity Type:Organization
Organization Name:E. JOSEPH LENZ DDS PC FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:319-377-1300
Mailing Address - Street 1:890 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-5747
Mailing Address - Country:US
Mailing Address - Phone:319-377-1300
Mailing Address - Fax:319-447-6085
Practice Address - Street 1:890 7TH AVE
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-5747
Practice Address - Country:US
Practice Address - Phone:319-377-1300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental