Provider Demographics
NPI:1598305823
Name:LENZ DENTAL, PLLC
Entity Type:Organization
Organization Name:LENZ DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:786-202-9024
Mailing Address - Street 1:13050 GRAN BAY PKWY UNIT 1445
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32258-4542
Mailing Address - Country:US
Mailing Address - Phone:786-202-9024
Mailing Address - Fax:
Practice Address - Street 1:13050 GRAN BAY PKWY UNIT 1445
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32258-4542
Practice Address - Country:US
Practice Address - Phone:786-202-9024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-15
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental