Provider Demographics
NPI:1497761803
Name:LORENZ, ROY M (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:M
Last Name:LORENZ
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14991 E HAMPDEN AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80014-3983
Mailing Address - Country:US
Mailing Address - Phone:303-690-2333
Mailing Address - Fax:
Practice Address - Street 1:14991 E HAMPDEN AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-3983
Practice Address - Country:US
Practice Address - Phone:303-690-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1049731223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics