Provider Demographics
NPI:1447478870
Name:LYONS DENTAL ASSOCIATES, D.M.D., PC
Entity type:Organization
Organization Name:LYONS DENTAL ASSOCIATES, D.M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:978-667-5807
Mailing Address - Street 1:572 BOSTON RD
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-3776
Mailing Address - Country:US
Mailing Address - Phone:978-667-5807
Mailing Address - Fax:978-667-8260
Practice Address - Street 1:572 BOSTON RD
Practice Address - Street 2:SUITE ONE
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-3776
Practice Address - Country:US
Practice Address - Phone:978-667-5807
Practice Address - Fax:978-667-8260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA188321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1871508259OtherPERIODONTIST
MA1255437851OtherENDODONTIST
MA1952437832OtherGENERAL