Provider Demographics
NPI:1689738114
Name:MONTEIRO, LURLENE T (DMD)
Entity Type:Individual
Prefix:DR
First Name:LURLENE
Middle Name:T
Last Name:MONTEIRO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:JENKINTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19046-2834
Mailing Address - Country:US
Mailing Address - Phone:215-885-7331
Mailing Address - Fax:
Practice Address - Street 1:1622 SPRING AVE
Practice Address - Street 2:
Practice Address - City:JENKINTOWN
Practice Address - State:PA
Practice Address - Zip Code:19046-2834
Practice Address - Country:US
Practice Address - Phone:215-885-7331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027046L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice