Provider Demographics
NPI:1154380913
Name:LENSE, PEDRO P (DMD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:P
Last Name:LENSE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7551 FOREST OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2437
Mailing Address - Country:US
Mailing Address - Phone:352-540-6800
Mailing Address - Fax:352-688-5047
Practice Address - Street 1:7551 FOREST OAKS BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2437
Practice Address - Country:US
Practice Address - Phone:352-540-6800
Practice Address - Fax:352-688-5047
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2013-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 00125211223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health