# CHARLES F. LYDY, D.D.S., P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093966640
- **Authorized official:** DR. CHARLES F LYDY D.D.S. (PRESIDENT)
- **Authorized official phone:** (989) 790-0700

## Contact information

- **Practice address:** 144 N FROST DR, SUITE 1, SAGINAW, MI 48638-7186
- **Practice address phone:** (989) 790-0700
- **Practice address fax:** (989) 790-7411
- **Mailing address:** 144 N FROST DR, SUITE 1, SAGINAW, MI 48638-7186
- **Mailing address phone:** (989) 790-0700
- **Mailing address fax:** (989) 790-7411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2008
- **Last updated:** 10/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4053826 | — | MI |