Provider Demographics
NPI:1033105101
Name:LYONS, WILLIAM EDWIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDWIN
Last Name:LYONS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2695 BECHELLI LANE
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96002
Mailing Address - Country:US
Mailing Address - Phone:530-222-4900
Mailing Address - Fax:530-222-0575
Practice Address - Street 1:2695 BECHELLI LANE
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002
Practice Address - Country:US
Practice Address - Phone:530-222-4900
Practice Address - Fax:530-222-0575
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA17124122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist