Provider Demographics
NPI:1508908914
Name:LOMBARDO, LOIS ANN (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOIS
Middle Name:ANN
Last Name:LOMBARDO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 CANDLESTICK RD
Mailing Address - Street 2:
Mailing Address - City:NORTH ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01845-3238
Mailing Address - Country:US
Mailing Address - Phone:978-474-0507
Mailing Address - Fax:978-409-6257
Practice Address - Street 1:68 PARK ST REAR
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-3693
Practice Address - Country:US
Practice Address - Phone:978-474-0507
Practice Address - Fax:978-409-6257
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA181341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice