Provider Demographics
NPI:1710630835
Name:LEHMANN FAMILY DENTAL PLLC
Entity Type:Organization
Organization Name:LEHMANN FAMILY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:MARSHALL
Authorized Official - Last Name:LEHMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:641-430-7104
Mailing Address - Street 1:108 S 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEAR LAKE
Mailing Address - State:IA
Mailing Address - Zip Code:50428-1940
Mailing Address - Country:US
Mailing Address - Phone:641-430-7104
Mailing Address - Fax:
Practice Address - Street 1:108 S 4TH ST
Practice Address - Street 2:
Practice Address - City:CLEAR LAKE
Practice Address - State:IA
Practice Address - Zip Code:50428-1940
Practice Address - Country:US
Practice Address - Phone:641-430-7104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-28
Last Update Date:2022-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental