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General NPI Number Information
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NPI Number | 1306068838
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Entity Type | Organization
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Legal Business Name | LISA JO ADORNETTO
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 12/23/2009
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Provider Practice Location Address
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Address Line | 3861 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-9438
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Country | US
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Telephone | 336-855-7182
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Fax |
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Provider Business Mailing Address
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Address Line | 3861 BATTLEGROUND AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-9438
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Country | US
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Telephone | 336-855-7182
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. LISA JO ADORNETTO
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Credential | DDS
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Telephone | 336-288-9878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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