Individual
PHILLIP HERBERT LORENZ SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2200 LOGAN AVE, CHEYENNE, WY 82001-4151
(307) 635-5560
(307) 772-7304
Mailing address
2200 LOGAN AVE, CHEYENNE, WY 82001-4151
(307) 635-5560
(307) 772-7304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1042
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1524775
UNITED CONCORDIA
WY
01
—
313462
BCBS
WY
Enumeration date
01/30/2007
Last updated
07/08/2007
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