Healthcare Provider Details

I. General information

NPI: 1568456838
Provider Name (Legal Business Name): CHRISTOPHER LENTO D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/01/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 CHURCH LN SUITE #3
EAST LYME CT
06333-1621
US

IV. Provider business mailing address

3 CEDARBROOK LN
EAST LYME CT
06333-1310
US

V. Phone/Fax

Practice location:
  • Phone: 860-691-0511
  • Fax: 860-739-9599
Mailing address:
  • Phone: 860-691-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number007873
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: