MEDICARE: DR. MICHAEL SEAN LORSCHEIDER DMD

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	4908896 9922	UT

General Provider Information

NPI Number	:	1528122074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL SEAN LORSCHEIDER DMD

Provider Business Mailing Address
First Line	:	10060 N 4600 W
Second Line	:
City	:	CEDAR HILLS
State	:	UT
Zip	:	84062
Country	:	US
Telephone Number	:	801-492-0402
Fax Number	:	801-492-0414

Provider Business Practice Location Address
First Line	:	10060 N 4600 W
Second Line	:
City	:	CEDAR HILLS
State	:	UT
Zip	:	84062
Country	:	US
Telephone Number	:	801-492-0402
Fax Number	:	801-492-0414

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

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	07/08/2007

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