Provider Demographics
NPI:1346622008
Name:EDWARD K LORENTS DDS PLLC
Entity Type:Organization
Organization Name:EDWARD K LORENTS DDS PLLC
Other - Org Name:DENTAL ARTS CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:K
Authorized Official - Last Name:LORENTS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-769-3373
Mailing Address - Street 1:10420 NE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73141-5216
Mailing Address - Country:US
Mailing Address - Phone:405-769-3373
Mailing Address - Fax:405-769-9938
Practice Address - Street 1:10420 NE 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73141-5216
Practice Address - Country:US
Practice Address - Phone:405-769-3373
Practice Address - Fax:405-769-9938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK64001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty