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Individual

DR. TANNER LORENZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
508 W PINE ST, FARMINGTON, MO 63640-1426
(573) 664-1100
Mailing address
208 HAWTHORNE DR, FARMINGTON, MO 63640-1151
(573) 315-9680

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2020017364
MO

Other

Enumeration date
06/22/2020
Last updated
07/27/2020
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