Provider Demographics
NPI:1346326725
Name:LORENTE, MARIA LISA (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:LISA
Last Name:LORENTE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 MAHALO DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-7863
Mailing Address - Country:US
Mailing Address - Phone:714-965-6292
Mailing Address - Fax:
Practice Address - Street 1:4940 IRVINE BLVD
Practice Address - Street 2:#203
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-1959
Practice Address - Country:US
Practice Address - Phone:714-730-0491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice