Provider Demographics
NPI:1669563540
Name:MINNITI, LORENZO (DDS)
Entity type:Individual
Prefix:
First Name:LORENZO
Middle Name:
Last Name:MINNITI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WING MILL RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-3139
Mailing Address - Country:US
Mailing Address - Phone:770-393-9360
Mailing Address - Fax:
Practice Address - Street 1:270 SAINT CLAIRE DR
Practice Address - Street 2:SUITE 105
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-5728
Practice Address - Country:US
Practice Address - Phone:678-990-8590
Practice Address - Fax:678-990-8594
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0129181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice