Provider Demographics
NPI:1255416962
Name:CANTU' LINDSEY, LORRA LORRAINE (DDS)
Entity type:Individual
Prefix:DR
First Name:LORRA
Middle Name:LORRAINE
Last Name:CANTU' LINDSEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5051 SOUTH SONCY,
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79119
Mailing Address - Country:US
Mailing Address - Phone:803-353-1055
Mailing Address - Fax:806-353-7077
Practice Address - Street 1:5051 SOUTH SONCY
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79119
Practice Address - Country:US
Practice Address - Phone:803-353-1055
Practice Address - Fax:806-353-7077
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2016-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX197831223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1449092-01Medicaid