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General NPI Number Information
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NPI Number | 1376523365
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Entity Type | Individual
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Provider Name | DONALD ALAN LONERGAN DMD
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Gender | Male
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Dates
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Enumeration Date | 01/18/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1 PINCKNEY BLVD
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City | BEAUFORT
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State | SD
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Zip | 29935
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Country | US
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Telephone | 843-228-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 6 FLAMINGO CV
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City | BEAUFORT
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State | SC
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Zip | 29907-1824
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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 |
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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 | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number | 019021154
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License Number State | IL
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