Paul M Lorentson, DDS

Individual provider Active NPI General Practice Dentistry · Marathon, WI

NPI 1912295080 · NPPES record last updated Jan 25, 2023

Key facts

NPI
1912295080
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
6751-15 (WI)
Practice address
981 Blue Stone LN
Marathon, WI 54448-6800
Phone
(715) 443-2200
NPI assigned
Jul 11, 2011
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
6751-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Marathon Family Dentistry, LLC Past
since Jan 29, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6751-15 WI Yes

Addresses

Primary practice location

981 Blue Stone LN
Marathon, WI 54448-6800

Mailing address

981 Blue Stone LN
Marathon, WI 54448-6800
Phone (715) 443-2200

Other providers in Marathon, WI

All providers in Marathon, WI · General Practice Dentistry in Wisconsin

Sources for this page

Verify at the official NPI Registry.