Healthcare Provider Details

I. General information

NPI: 1902964018
Provider Name (Legal Business Name): LYERLY & ASSOCIATES DDS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5980 US HWY 52
SALISBURY NC
28146-8138
US

IV. Provider business mailing address

PO BOX 328
GRANITE QUARRY NC
28072-0328
US

V. Phone/Fax

Practice location:
  • Phone: 704-279-5400
  • Fax: 704-279-2476
Mailing address:
  • Phone: 704-279-5400
  • Fax: 704-279-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number3070
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number7537
License Number StateNC

VIII. Authorized Official

Name: DR. ALAN RAY LYERLY
Title or Position: PRESIDENT LYERLY & ASSOCIATES DDS P
Credential: DDS
Phone: 704-279-5400