Provider Demographics
NPI:1972859247
Name:MICHAEL H LERNER ESTATE
Entity Type:Organization
Organization Name:MICHAEL H LERNER ESTATE
Other - Org Name:MICHAEL H LERNER DMD, MSD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LERNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-223-0009
Mailing Address - Street 1:3101 CLAYS MILL RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2772
Mailing Address - Country:US
Mailing Address - Phone:859-223-0009
Mailing Address - Fax:
Practice Address - Street 1:3101 CLAYS MILL RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2772
Practice Address - Country:US
Practice Address - Phone:859-223-0009
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental