Provider Demographics
NPI:1619126448
Name:LAKRITZ, LOWELL S
Entity Type:Individual
Prefix:DR
First Name:LOWELL
Middle Name:S
Last Name:LAKRITZ
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:LOWELL
Other - Middle Name:SEYMOUR
Other - Last Name:LAKRITZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:5822 DORSETT DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-3406
Mailing Address - Country:US
Mailing Address - Phone:608-271-8419
Mailing Address - Fax:
Practice Address - Street 1:5822 DORSETT DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3406
Practice Address - Country:US
Practice Address - Phone:608-271-8419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-17
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4001701-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist