Basic Information
| Provider Information | |||||||||
| NPI: | 1043446016 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TSENG | ||||||||
| FirstName: | LORRAINE | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | D.D.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1021 SPRING ST | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370583302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9312325329 | ||||||||
| FaxNumber: | 9312327247 | ||||||||
| Practice Location | |||||||||
| Address1: | 1021 SPRING ST | ||||||||
| Address2: | |||||||||
| City: | DOVER | ||||||||
| State: | TN | ||||||||
| PostalCode: | 370583302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9312325329 | ||||||||
| FaxNumber: | 9312327247 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2009 | ||||||||
| LastUpdateDate: | 06/04/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 122300000X | DS0000008461 | TN | Y | Dental Providers | Dentist | 122300000X | 36873 | CA | N | Dental Providers | Dentist |
No ID Information.