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General NPI Number Information
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NPI Number | 1407058134
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Entity Type | Individual
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Provider Name | THOMAS LYONS JR. D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3298 SUMMIT BLVD STE 39
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City | PENSACOLA
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State | FL
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Zip | 32503-4350
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Country | US
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Telephone | 850-438-1777
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Fax | 850-438-1775
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Provider Business Mailing Address
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Address Line | 3298 SUMMIT BLVD STE 39
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City | PENSACOLA
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State | FL
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Zip | 32503-4350
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Country | US
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Telephone | 850-438-1777
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Fax | 850-438-1775
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN15403
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License Number State | FL
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