Provider Demographics
NPI:1851519706
Name:GARRETT B. LYONS D.D.S. P.A.
Entity Type:Organization
Organization Name:GARRETT B. LYONS D.D.S. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:BROWNE
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-654-1765
Mailing Address - Street 1:100 WEST ROCKLAND ROAD
Mailing Address - Street 2:SUITE P-1
Mailing Address - City:MONTCHANIN
Mailing Address - State:DE
Mailing Address - Zip Code:19710-0295
Mailing Address - Country:US
Mailing Address - Phone:302-654-1765
Mailing Address - Fax:302-777-1883
Practice Address - Street 1:100 WEST ROCKLAND ROAD
Practice Address - Street 2:SUITE P-1
Practice Address - City:MONTCHANIN
Practice Address - State:DE
Practice Address - Zip Code:19710-0295
Practice Address - Country:US
Practice Address - Phone:302-654-1765
Practice Address - Fax:302-777-1883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty