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General NPI Number Information
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NPI Number | 1629981543
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Entity Type | Organization
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Legal Business Name | LISA CANDON, DDS, PLLC
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Dates
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Enumeration Date | 09/23/2026
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Last Update Date | 09/23/2026
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Provider Practice Location Address
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Address Line | 14722 LAWYERS RD
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City | MATTHEWS
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State | NC
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Zip | 28104
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Country | US
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Telephone | 704-322-4496
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Fax | 704-322-4498
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Provider Business Mailing Address
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Address Line | 212 PUMPKIN SEED CT
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City | MATTHEWS
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State | NC
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Zip | 28104-0006
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Country | US
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Telephone | 704-763-8188
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LISA CANDON
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Credential | DDS
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Telephone | 704-763-8188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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