Provider Demographics
NPI:1477563997
Name:POLLARD, LONNIE M (DDS11/)
Entity Type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:M
Last Name:POLLARD
Suffix:
Gender:M
Credentials:DDS11/
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4238 SHERWOOD WAY, STE.3
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76901-3596
Mailing Address - Country:US
Mailing Address - Phone:325-949-1732
Mailing Address - Fax:325-949-0828
Practice Address - Street 1:4238 SHERWOOD WAY STE 3
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76901-3596
Practice Address - Country:US
Practice Address - Phone:325-949-1732
Practice Address - Fax:325-949-0828
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice