Lester James Rentz Jr., D.M.D.

Individual provider Active NPI General Practice Dentistry · Lake Park, GA

NPI 1356376255 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1356376255
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN013123 (GA)
Practice address
3012 U.S. Hwy 41 South
Lake Park, GA 31636-3467
Phone
(229) 559-4700
Fax
(229) 559-5009
NPI assigned
Jul 11, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN013123GAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013123 GA Yes

Addresses

Primary practice location

3012 U.S. Hwy 41 South
Lake Park, GA 31636-3467

Mailing address

3012 U.S. Highway 41 South
Lake Park, GA 31636-3467
Phone (229) 559-4700

Other providers in Lake Park, GA

All providers in Lake Park, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.