Individual
LYNETTE C FORTENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
1220 12TH ST SE, WASHINGTON, DC 20003-3722
(202) 715-7900
(202) 544-2714
Mailing address
1220 12TH ST SE, WASHINGTON, DC 20003-3722
(202) 715-7900
(202) 544-2714
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019024964
IL
Other
Enumeration date
11/30/2006
Last updated
03/07/2023
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