Basic Information
Provider Information
NPI: 1356561401
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PRETTO
FirstName: LORENA
MiddleName: P
NamePrefix:  
NameSuffix:  
Credential: D.D.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 40 BURTON HILLS BLVD
Address2: SUITE 200
City: NASHVILLE
State: TN
PostalCode: 372156155
CountryCode: US
TelephoneNumber: 6155651733
FaxNumber: 6152960151
Practice Location
Address1: 1 LONE STAR PASS
Address2: BLDG 46
City: SAN ANTONIO
State: TX
PostalCode: 782643638
CountryCode: US
TelephoneNumber: 2102635700
FaxNumber: 2102635701
Other Information
ProviderEnumerationDate: 04/30/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
122300000X14990TXY Dental ProvidersDentist 

No ID Information.


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