Provider Demographics
NPI:1003046665
Name:ECKMAN, LONNIE CHRIS (DMD)
Entity Type:Individual
Prefix:
First Name:LONNIE
Middle Name:CHRIS
Last Name:ECKMAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7725 N 43RD AVE STE NO711
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-5770
Mailing Address - Country:US
Mailing Address - Phone:623-931-8898
Mailing Address - Fax:623-930-1182
Practice Address - Street 1:7725 N 43RD AVE STE NO711
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5770
Practice Address - Country:US
Practice Address - Phone:623-931-8898
Practice Address - Fax:623-930-1182
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2009-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD78301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice