MEDICARE: DAVID M LOMASNEY DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	17518	MI

General Provider Information

NPI Number	:	1114033099
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID M LOMASNEY DDS PC

Provider Business Mailing Address
First Line	:	1017 HURON AVENUE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060
Country	:	US
Telephone Number	:	810-989-4746
Fax Number	:	810-982-2209

Provider Business Practice Location Address
First Line	:	1017 HURON AVENUE
Second Line	:
City	:	PORT HURON
State	:	MI
Zip	:	48060
Country	:	US
Telephone Number	:	810-989-4746
Fax Number	:	810-982-2209

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DAVID M LOMASNEY
Credential	:	DDS
Telephone Number	:	810-989-4746

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	08/22/2020

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