MEDICARE: DR. ROY G LANZ 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	DS017992L	PA

General Provider Information

NPI Number	:	1720139421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROY G LANZ DMD

Provider Business Mailing Address
First Line	:	750 WASHINGTON RD
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15228-2051
Country	:	US
Telephone Number	:	412-343-2022
Fax Number	:

Provider Business Practice Location Address
First Line	:	750 WASHINGTON RD
Second Line	:
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	:	01/16/2007
Last Update Date	:	07/08/2007

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