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Individual
DR. LISA G FONAS
Active
Individual
DR. LISA G FONAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DN15554
FL
122300000X
Dentist
Primary
DS030795 L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001758003
—
PA
Enumeration date
12/18/2006
Last updated
06/28/2016
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