Provider Demographics
NPI:1578842001
Name:LOCKHART, LAUREN RENNICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:RENNICK
Last Name:LOCKHART
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 1:2620 W ARROWOOD RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6199
Mailing Address - Country:US
Mailing Address - Phone:704-269-8495
Mailing Address - Fax:
Practice Address - Street 1:2620 W ARROWOOD RD
Practice Address - Street 2:SUITE 102
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6199
Practice Address - Country:US
Practice Address - Phone:704-269-8495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-15
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC95901223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics