Provider Demographics
NPI:1508928854
Name:LENTZ, JOHN DENLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DENLEY
Last Name:LENTZ
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:PO BOX 182
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24212
Mailing Address - Country:US
Mailing Address - Phone:276-620-2144
Mailing Address - Fax:276-628-2145
Practice Address - Street 1:350 E MAIN STREET
Practice Address - Street 2:
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24210
Practice Address - Country:US
Practice Address - Phone:276-628-2144
Practice Address - Fax:276-628-2145
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401004887122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist