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General NPI Number Information
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NPI Number | 1245497718
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Entity Type | Organization
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Legal Business Name | MICHAEL F. LYONS, D.M.D., P.C,
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/21/2008
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Provider Practice Location Address
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Address Line | 634 WESTERN AVE
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City | ALBANY
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State | NY
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Zip | 12203-1830
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Country | US
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Telephone | 518-489-5458
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Fax | 518-489-5668
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Provider Business Mailing Address
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Address Line | 634 WESTERN AVE
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City | ALBANY
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State | NY
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Zip | 12203-1830
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Country | US
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Telephone | 518-489-5458
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Fax | 518-489-5668
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL F LYONS
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Credential | D.M.D.
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Telephone | 518-489-5458
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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 | 38840
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License Number State | NY
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