Provider Demographics
NPI:1467516799
Name:LENERS, DORIS GULL
Entity Type:Individual
Prefix:DR
First Name:DORIS
Middle Name:GULL
Last Name:LENERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 MANUFACTURING DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732-6730
Mailing Address - Country:US
Mailing Address - Phone:563-242-4917
Mailing Address - Fax:563-242-4943
Practice Address - Street 1:1801 MANUFACTURING DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-6730
Practice Address - Country:US
Practice Address - Phone:563-242-4917
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA071041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice