Organization
LYONS DENTAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW AARON PERRY DMD (DR)
(620) 257-5193
Entity
Organization
Contact information
Practice address
220 W COMMERCIAL ST, LYONS, KS 67554-2716
(620) 257-5193
Mailing address
PO BOX 696, LYONS, KS 67554-0696
(620) 257-5193
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4387
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100095610A
—
KS
01
—
8289
BLUE CROSS BLUE SHIELD
KS
Enumeration date
09/14/2006
Last updated
05/09/2018
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