Provider Demographics
NPI:1376873141
Name:ANGELA S. LUTZ, D.M.D., L.L.C.
Entity Type:Organization
Organization Name:ANGELA S. LUTZ, D.M.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:LUTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:717-741-0848
Mailing Address - Street 1:2200 S GEORGE ST
Mailing Address - Street 2:PLAZA B
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4594
Mailing Address - Country:US
Mailing Address - Phone:717-741-0848
Mailing Address - Fax:717-741-9366
Practice Address - Street 1:2200 S GEORGE ST
Practice Address - Street 2:PLAZA B
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4594
Practice Address - Country:US
Practice Address - Phone:717-741-0848
Practice Address - Fax:717-741-9366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-30
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty