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General NPI Number Information
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NPI Number | 1376700898
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Entity Type | Organization
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Legal Business Name | LECHTENBERG DENTAL CLINIC
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 129 W PLEASANT ST
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City | MAQUOKETA
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State | IA
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Zip | 52060-3046
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Country | US
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Telephone | 563-652-3438
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Fax | 563-652-0138
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Provider Business Mailing Address
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Address Line | 129 W PLEASANT ST
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City | MAQUOKETA
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State | IA
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Zip | 52060-3046
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Country | US
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Telephone | 563-652-3438
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Fax | 563-652-0138
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. JOSEPH A LECHTENBERG JR.
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Credential | DDS
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Telephone | 563-652-3438
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7451
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License Number State | IA
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