Provider Demographics
NPI:1801861570
Name:JOYCE, LISA COLETTE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:COLETTE
Last Name:JOYCE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1813 WILSON ST
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-1406
Mailing Address - Country:US
Mailing Address - Phone:715-235-7566
Mailing Address - Fax:715-235-7578
Practice Address - Street 1:1813 WILSON ST
Practice Address - Street 2:
Practice Address - City:MENOMONIE
Practice Address - State:WI
Practice Address - Zip Code:54751-1406
Practice Address - Country:US
Practice Address - Phone:715-235-7566
Practice Address - Fax:715-235-7578
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI43231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice