Provider Demographics
NPI:1598846313
Name:MUFF, LISA A (DMD)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:A
Last Name:MUFF
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 1:1505 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8329
Mailing Address - Country:US
Mailing Address - Phone:610-559-8001
Mailing Address - Fax:610-559-8605
Practice Address - Street 1:1505 SULLIVAN TRL
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8329
Practice Address - Country:US
Practice Address - Phone:610-559-8001
Practice Address - Fax:610-559-8605
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026862L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA675046Medicare UPIN