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General NPI Number Information
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NPI Number | 1598871477
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Entity Type | Individual
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Provider Name | JOAN LENZE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2230 W OLD HWY 441
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City | MOUNT DORA
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State | FL
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Zip | 32757
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Country | US
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Telephone | 352-383-2959
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Fax | 352-735-3355
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Provider Business Mailing Address
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Address Line | 2230 WEST OLD HIGHWAT 441
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City | MOUNT DORA
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State | FL
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Zip | 32757
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Country | US
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Telephone |
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Fax |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | DN0006360
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License Number State | FL
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