Provider Demographics
NPI:1205016862
Name:ERIC W. LERNOR, DDS PC
Entity Type:Organization
Organization Name:ERIC W. LERNOR, DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:WARREN
Authorized Official - Last Name:LERNOR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:602-485-4747
Mailing Address - Street 1:4747 E BELL RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2301
Mailing Address - Country:US
Mailing Address - Phone:602-485-4747
Mailing Address - Fax:602-485-0123
Practice Address - Street 1:4747 E BELL RD
Practice Address - Street 2:SUITE 7
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2301
Practice Address - Country:US
Practice Address - Phone:602-485-4747
Practice Address - Fax:602-485-0123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-11
Last Update Date:2007-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3302261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental