Individual
DR. LISA MCDANIEL WENTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4013-84TH ST, LUBBOCK, TX 79423
(806) 794-8365
Mailing address
2 S LAKESHORE DR, RANSOM CANYON, TX 79366-2412
(806) 745-1812
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
15004
TX
Other
Enumeration date
10/24/2006
Last updated
07/08/2007
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