Provider Demographics
NPI:1538209028
Name:LORENZO, STEVEN CHRISTOPHER (DMD)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:CHRISTOPHER
Last Name:LORENZO
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 1:1101 S BROAD ST
Mailing Address - Street 2:PO BOX 622
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5870
Mailing Address - Country:US
Mailing Address - Phone:215-855-1088
Mailing Address - Fax:215-855-5384
Practice Address - Street 1:1101 S BROAD ST
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5870
Practice Address - Country:US
Practice Address - Phone:215-855-1088
Practice Address - Fax:215-855-5384
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS029495L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
793153OtherUCCI