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General NPI Number Information
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NPI Number | 1225455637
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Entity Type | Organization
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Legal Business Name | LISA A. LEAR, DDS, MSD, PC
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Dates
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Enumeration Date | 03/24/2014
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Last Update Date | 03/24/2014
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Provider Practice Location Address
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Address Line | 6367 E TANQUE VERDE RD SUITE 210
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City | TUCSON
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State | AZ
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Zip | 85715-3829
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Country | US
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Telephone | 520-577-3935
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Fax |
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Provider Business Mailing Address
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Address Line | 6367 E TANQUE VERDE RD SUITE 210
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City | TUCSON
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State | AZ
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Zip | 85715-3829
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Country | US
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Telephone | 520-577-3935
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LISA A. LEAR
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Credential | DDS, MSD
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Telephone | 520-577-3938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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