Provider Demographics
NPI:1942353925
Name:LUTZ, ANGELA S (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANGELA
Middle Name:S
Last Name:LUTZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2200 S GEORGE ST
Mailing Address - Street 2:PLAZA B
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17403-4594
Mailing Address - Country:US
Mailing Address - Phone:717-741-0848
Mailing Address - Fax:717-741-9366
Practice Address - Street 1:2200 S GEORGE ST
Practice Address - Street 2:PLAZA B
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17403-4594
Practice Address - Country:US
Practice Address - Phone:717-741-0848
Practice Address - Fax:717-741-9366
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PADS-030709-L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry