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General NPI Number Information
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NPI Number | 1215945829
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Entity Type | Individual
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Provider Name | ELIZEU S. LIMA DMD
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 909 N MAIN ST
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City | PROVIDENCE
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State | RI
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Zip | 02904-5752
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Country | US
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Telephone | 401-272-1238
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Fax | 401-272-1468
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Provider Business Mailing Address
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Address Line | 948 VETERANS MEMORIAL PKWY
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City | RIVERSIDE
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State | RI
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Zip | 02915-5025
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Country | US
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Telephone | 401-435-3104
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Fax | 401-438-0665
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2531
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License Number State | RI
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