Organization
MARY LEAH T. LORENZO DDS INC
Active
Other names
MARY LEAHT. LORENZO DDS INC
Organization subpart
No
Provider details
NPI number
Authorized official
MARY LEAH TAN LORENZO DDS (PRESIDENT)
(818) 645-7375
Entity
Organization
Contact information
Practice address
9535 RESEDA BLVD STE 213, NORTHRIDGE, CA 91324-6028
(818) 718-2566
Mailing address
8424 TUNNEY AVE, NORTHRIDGE, CA 91324-4263
(818) 645-7375
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
08/19/2022
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