MEDICARE: DR. MATTHEW JAMES LANZ D.M.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DS036152	PA

General Provider Information

NPI Number	:	1245310390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATTHEW JAMES LANZ D.M.D

Provider Business Mailing Address
First Line	:	2388 HILLTOP RD
Second Line	:
City	:	PRESTO
State	:	PA
Zip	:	15142-1122
Country	:	US
Telephone Number	:	412-952-6330
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 WASHINGTON RD
Second Line	:	SUITE 6&7
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-2051
Country	:	US
Telephone Number	:	412-343-2022
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/08/2007

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