Provider Demographics
NPI:1447457411
Name:LORENZ, RACHEL LISA (DMD, MMSC)
Entity type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:LISA
Last Name:LORENZ
Suffix:
Gender:F
Credentials:DMD, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 NEWCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2637
Mailing Address - Country:US
Mailing Address - Phone:617-827-9150
Mailing Address - Fax:
Practice Address - Street 1:409 POND ST
Practice Address - Street 2:SUITE 5
Practice Address - City:BRAINTREE
Practice Address - State:MA
Practice Address - Zip Code:02184-6850
Practice Address - Country:US
Practice Address - Phone:781-848-6422
Practice Address - Fax:781-848-0338
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212821223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics