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NPI Code Detail

MEDICARE: LONNIE LINDSTROM HYGIENIST

MEDICARE: LONNIE LINDSTROM HYGIENIST
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
1124Q00000XDental Hygienist0856NV

General Provider Information

NPI Number : 1477678720
Entity Type Code : Individual
Provider Name (Legal Business Name) : LONNIE LINDSTROM HYGIENIST
Provider Business Mailing Address
First Line : 1055 S WELLS AVE
Second Line : SUITE 120
City : RENO
State : NV
Zip : 89502-2586
Country : US
Telephone Number : 775-336-3021
Fax Number : 775-348-3896
Provider Business Practice Location Address
First Line : 1055 S WELLS AVE
Second Line : SUITE 120
City : RENO
State : NV
Zip : 89502-2586
Country : US
Telephone Number : 775-336-3021
Fax Number : 775-348-3896
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/19/2007
Last Update Date : 07/08/2007

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Directions to “ LONNIE LINDSTROM HYGIENIST” Practice Location

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