Provider Demographics
NPI:1225455637
Name:LISA A. LEAR, DDS, MSD, PC
Entity Type:Organization
Organization Name:LISA A. LEAR, DDS, MSD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:520-577-3938
Mailing Address - Street 1:6367 E TANQUE VERDE RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-3829
Mailing Address - Country:US
Mailing Address - Phone:520-577-3935
Mailing Address - Fax:
Practice Address - Street 1:6367 E TANQUE VERDE RD
Practice Address - Street 2:SUITE 210
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-3829
Practice Address - Country:US
Practice Address - Phone:520-577-3935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-24
Last Update Date:2014-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty