Healthcare Provider Details

I. General information

NPI: 1992805378
Provider Name (Legal Business Name): ROBERT PRESTON LENTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PRESTON LENTZ MD

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 01/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4529 JESSUP GROVE RD
GREENSBORO NC
27410-9407
US

IV. Provider business mailing address

4529 JESSUP GROVE RD
GREENSBORO NC
27410
US

V. Phone/Fax

Practice location:
  • Phone: 336-605-0190
  • Fax: 336-605-0930
Mailing address:
  • Phone: 336-605-0190
  • Fax: 336-605-0930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number29136
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: