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Provider Information for 1306966072

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. RICHARD LESTZ D.D.S

Gender: MALE

Individual NPI: 1306966072

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1306966072
Enumeration Date 2007-03-29
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 11045 QUEENS BLVD SUITE 109
FOREST HILLS, NY 11375-5501
United States

Phone: 718-544-9100 | Fax: 718-544-1098
View Map External Link
Primary Practice Address 11045 QUEENS BLVD SUITE 109
FOREST HILLS, NY 11375-5501
United States

Phone: 718-544-9100 | Fax: 718-544-1098
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice NY 033630