Provider Demographics
NPI:1811067093
Name:LORENZO, EUDEL OLPINDO (DDS)
Entity type:Individual
Prefix:DR
First Name:EUDEL
Middle Name:OLPINDO
Last Name:LORENZO
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 1:3706 SENECA AVENUE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039
Mailing Address - Country:US
Mailing Address - Phone:323-913-0997
Mailing Address - Fax:323-913-0997
Practice Address - Street 1:2950 LOS FELIZ BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039
Practice Address - Country:US
Practice Address - Phone:323-356-6844
Practice Address - Fax:323-913-0997
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist