Provider Demographics
NPI:1437541760
Name:LOTZ, ALENA REICH (DMD)
Entity type:Individual
Prefix:
First Name:ALENA
Middle Name:REICH
Last Name:LOTZ
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4480 N COOPER LAKE RD SE STE 220
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30082-4623
Mailing Address - Country:US
Mailing Address - Phone:770-742-2882
Mailing Address - Fax:770-742-2883
Practice Address - Street 1:4480 N COOPER LAKE RD SE STE 220
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:GA
Practice Address - Zip Code:30082-4623
Practice Address - Country:US
Practice Address - Phone:770-742-2882
Practice Address - Fax:770-742-2883
Is Sole Proprietor?:No
Enumeration Date:2015-02-24
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0150871223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics