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NPI 1326226176

NPI 1326226176 : JOHN A. LYONS, DDS, PA : GASTONIA, NC

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General NPI Number Information
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    NPI Number           |    1326226176
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    Entity Type          |    Organization 
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    Legal Business Name  |    JOHN A. LYONS, DDS, PA 
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Dates
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    Enumeration Date     |    02/04/2008
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    Last Update Date     |    02/04/2008
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Provider Practice Location Address
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    Address Line         |    816 E FRANKLIN BLVD 
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    City                 |    GASTONIA
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    State                |    NC
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    Zip                  |    28054-4241
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    Country              |    US
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    Telephone            |    704-516-0335
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    816 E FRANKLIN BLVD 
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    City                 |    GASTONIA
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    State                |    NC
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    Zip                  |    28054-4241
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    Country              |    US
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    Telephone            |    
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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. JOHN  LYONS 
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    Credential           |    
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    Telephone            |    704-516-0335
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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       |    7457
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    License Number State |    NC
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