Provider Demographics
NPI:1023174976
Name:LENTZ, DAVID PATRICK (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:PATRICK
Last Name:LENTZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 108
Mailing Address - Street 2:
Mailing Address - City:JONES MILLS
Mailing Address - State:PA
Mailing Address - Zip Code:15646
Mailing Address - Country:US
Mailing Address - Phone:724-593-6100
Mailing Address - Fax:724-593-6102
Practice Address - Street 1:268 ROUTE 711
Practice Address - Street 2:
Practice Address - City:JONES MILLS
Practice Address - State:PA
Practice Address - Zip Code:15646
Practice Address - Country:US
Practice Address - Phone:724-593-6100
Practice Address - Fax:724-596-6102
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029987L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA970647OtherUNITED CONCORDIA