Provider Demographics
NPI:1245497718
Name:MICHAEL F. LYONS, D.M.D., P.C,
Entity type:Organization
Organization Name:MICHAEL F. LYONS, D.M.D., P.C,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:F
Authorized Official - Last Name:LYONS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:518-489-5458
Mailing Address - Street 1:634 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1830
Mailing Address - Country:US
Mailing Address - Phone:518-489-5458
Mailing Address - Fax:518-489-5668
Practice Address - Street 1:634 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203-1830
Practice Address - Country:US
Practice Address - Phone:518-489-5458
Practice Address - Fax:518-489-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-21
Last Update Date:2008-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY388401223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty