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General NPI Number Information
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NPI Number | 1770694432
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Entity Type | Organization
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Legal Business Name | LIONEL W. NOONAN, JR. DMD, PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 27985 US HIGHWAY 98
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City | DAPHNE
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State | AL
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Zip | 36526-4722
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Country | US
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Telephone | 251-626-2141
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Fax | 251-626-7011
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Provider Business Mailing Address
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Address Line | 27985 US HIGHWAY 98
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City | DAPHNE
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State | AL
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Zip | 36526-4722
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Country | US
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Telephone | 251-626-2141
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Fax | 251-626-7011
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Authorized Official
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Title or Position | CORPORATION PRESIDENT
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Name | DR. LIONEL WINSTON NOONAN JR.
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Credential | DMD
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Telephone | 251-626-2141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | LNO 4656
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License Number State | AL
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