Provider Demographics
NPI:1790904787
Name:LORENZ, ROBERT M (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:M
Last Name:LORENZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 CENTENNIAL DR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-1302
Mailing Address - Country:US
Mailing Address - Phone:303-665-7505
Mailing Address - Fax:303-664-9941
Practice Address - Street 1:1760 CENTENNIAL DR
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1302
Practice Address - Country:US
Practice Address - Phone:303-665-7505
Practice Address - Fax:303-664-9941
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO104857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist