Provider Demographics
NPI:1639649288
Name:R A LOMBARDI DDS PC
Entity Type:Organization
Organization Name:R A LOMBARDI DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:R
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:815-254-6900
Mailing Address - Street 1:3011 THEODORE ST
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5288
Mailing Address - Country:US
Mailing Address - Phone:815-254-6900
Mailing Address - Fax:815-254-9268
Practice Address - Street 1:3011 THEODORE ST
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5288
Practice Address - Country:US
Practice Address - Phone:815-254-6900
Practice Address - Fax:815-254-9268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-27
Last Update Date:2018-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty