Individual
DR. JEFFREY LYSDALE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2311 S CASINO DR STE D, LAUGHLIN, NV 89029-1534
(702) 298-4545
Mailing address
1830 KIRK DRIVE, LAKE HAVASU CITY, AZ 86404
(949) 351-7343
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4186
NV
Other
Enumeration date
05/24/2007
Last updated
08/20/2008
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