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General NPI Number Information
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NPI Number | 1598815268
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Entity Type | Individual
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Provider Name | MOLLY E LANZ D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 265 3RD ST
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City | BEAVER
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State | PA
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Zip | 15009-2350
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Country | US
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Telephone | 724-774-1920
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Fax | 724-774-3332
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Provider Business Mailing Address
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Address Line | 265 3RD ST PO BOX 265
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City | BEAVER
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State | PA
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Zip | 15009-2350
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Country | US
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Telephone | 724-774-1920
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Fax | 724-774-3332
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | DS-035146
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License Number State | PA
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