Provider Demographics
NPI:1790090298
Name:LEHNERTZ, CYNTHIA D (DMD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:D
Last Name:LEHNERTZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8700 NE VANCOUVER MALL DR
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6750
Mailing Address - Country:US
Mailing Address - Phone:360-254-8880
Mailing Address - Fax:360-254-8383
Practice Address - Street 1:8700 NE VANCOUVER MALL DR
Practice Address - Street 2:SUITE 202A
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98662-6750
Practice Address - Country:US
Practice Address - Phone:360-254-8880
Practice Address - Fax:360-254-8385
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60171335122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist