Provider Demographics
NPI:1467674473
Name:LINTZENICH, DONALD L (DDS)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:L
Last Name:LINTZENICH
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 1:4789 ALBERTON CT
Mailing Address - Street 2:#3204
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34105
Mailing Address - Country:US
Mailing Address - Phone:239-694-9993
Mailing Address - Fax:239-561-9996
Practice Address - Street 1:13432 PALM BEACH BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33905
Practice Address - Country:US
Practice Address - Phone:239-694-0834
Practice Address - Fax:239-694-7014
Is Sole Proprietor?:No
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN004641122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist