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General NPI Number Information
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NPI Number | 1619105509
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Entity Type | Individual
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Provider Name | NICHOLAS J. LYONS D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/30/2009
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 40TH AND HOLDREGE STREETS
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City | LINCOLN
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State | NE
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Zip | 68583
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Country | US
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Telephone | 406-720-0523
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Fax |
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Provider Business Mailing Address
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Address Line | 40TH AND HOLDREGE STREET UNMC SCHOOL OF DENTISTRY
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City | LINCOLN
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State | NE
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Zip | 68583
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Country | US
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Telephone | 406-720-0523
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2301
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License Number State | MT
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