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General NPI Number Information
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NPI Number | 1710984463
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Entity Type | Organization
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Legal Business Name | LYNETTE M. MCDONALD DDS PA
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Dates
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Enumeration Date | 07/07/2005
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Last Update Date | 06/13/2012
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Provider Practice Location Address
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Address Line | 2537B RAEFORD RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5161
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Country | US
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Telephone | 910-433-4600
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Fax | 910-486-6995
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Provider Business Mailing Address
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Address Line | 2537B RAEFORD RD
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City | FAYETTEVILLE
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State | NC
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Zip | 28305-5161
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Country | US
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Telephone | 910-433-4600
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Fax | 910-486-6995
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | MS. LYNETTE M MCDONALD
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Credential | DDS
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Telephone | 910-433-4600
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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 | 5513
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License Number State | NC
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