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Individual

LONNY D CARMICHAEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
3592 S ATHERTON BLVD, SUITE 107, GILBERT, AZ 85297-7443
(480) 889-1877
(480) 889-1876
Mailing address
3592 S ATHERTON BLVD, SUITE 107, GILBERT, AZ 85297-7443
(480) 889-1877
(480) 889-1876

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
0401411545
VA
1223P0221X
Pediatric Dentistry
Primary
7460
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
348451
AZ
Enumeration date
02/13/2007
Last updated
08/07/2009
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