Provider Demographics
NPI:1336301266
Name:LERNER, LANCE L (DDS)
Entity Type:Individual
Prefix:DR
First Name:LANCE
Middle Name:L
Last Name:LERNER
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 1:8157 BRIDGER CANYON RD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8247
Mailing Address - Country:US
Mailing Address - Phone:406-580-5630
Mailing Address - Fax:
Practice Address - Street 1:1994 STADIUM DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-0655
Practice Address - Country:US
Practice Address - Phone:406-587-0767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-01
Last Update Date:2008-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17991223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery