Individual
DR. LYDIA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
99 JOHN ST, 1608, NEW YORK, NY 10038-2903
(443) 306-6392
Mailing address
99 JOHN ST, 1608, NEW YORK, NY 10038-2903
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
056640
NY
1223P0300X
Periodontics
DS038532
PA
Other
Enumeration date
06/08/2011
Last updated
01/22/2014
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