Provider Demographics
NPI:1568536084
Name:DR. DALE D. LENTZ
Entity Type:Organization
Organization Name:DR. DALE D. LENTZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DALE
Authorized Official - Middle Name:D
Authorized Official - Last Name:LENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:480-838-5675
Mailing Address - Street 1:7350 S MCCLINTOCK DR STE 101
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85283-5006
Mailing Address - Country:US
Mailing Address - Phone:480-838-5675
Mailing Address - Fax:480-491-3541
Practice Address - Street 1:7350 S MCCLINTOCK DR STE 101
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-5006
Practice Address - Country:US
Practice Address - Phone:480-838-5675
Practice Address - Fax:480-491-3541
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ17151223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty