Provider Demographics
NPI:1164570891
Name:LOMBARDI DENTAL LLC
Entity Type:Organization
Organization Name:LOMBARDI DENTAL LLC
Other - Org Name:LOMBARDI FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RONALD
Authorized Official - Last Name:MEIER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:920-498-8877
Mailing Address - Street 1:1400 LOMBARDI AVE
Mailing Address - Street 2:SUITE 50
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54304-3922
Mailing Address - Country:US
Mailing Address - Phone:920-498-8877
Mailing Address - Fax:
Practice Address - Street 1:1400 LOMBARDI AVE
Practice Address - Street 2:SUITE 50
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54304-3922
Practice Address - Country:US
Practice Address - Phone:920-498-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI52301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty