Provider Demographics
NPI:1518017722
Name:LENZ, LEE ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:ANN
Last Name:LENZ
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 34TH AVE N
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52732
Mailing Address - Country:US
Mailing Address - Phone:563-243-6006
Mailing Address - Fax:
Practice Address - Street 1:5958 SNOW HILL RD
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-7833
Practice Address - Country:US
Practice Address - Phone:423-803-4500
Practice Address - Fax:423-803-4501
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA07744122300000X
TNDS00000105961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist