# DR. LISA G FONAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1710040340
- **Gender:** F
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | DN15554 | FL | — |
| 122300000X | Dentist | DS030795 L | PA | Yes |

## Other

- **Enumeration date:** 12/18/2006
- **Last updated:** 06/28/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001758003 | — | PA |