Provider Demographics
NPI:1891930004
Name:LISA B. EMIRZIAN DMD & ASSOC
Entity Type:Organization
Organization Name:LISA B. EMIRZIAN DMD & ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:COLLEEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:NADEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:413-586-4510
Mailing Address - Street 1:12 CENTER ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3005
Mailing Address - Country:US
Mailing Address - Phone:413-586-4510
Mailing Address - Fax:
Practice Address - Street 1:12 CENTER ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3005
Practice Address - Country:US
Practice Address - Phone:413-586-4510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2008-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty