Individual
DR. RAY A. LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS,FADPD, DABSCD
Contact information
Practice address
7905 MARBLE AVE NE, ALBUQUERQUE, NM 87110-7886
(505) 232-5710
Mailing address
PO BOX 1269, LOS LUNAS COMMUNITY PROGRAM, LOS LUNAS, NM 87031-1269
(505) 222-0919
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD1302
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004093
DORAL DENTAL
NM
01
—
0007343702
AETNA
NM
01
—
631452
UNITED CONCORDIA
NM
01
—
8808
DELTA DENTAL
NM
01
—
8942
BC/BS
NM
05
—
K8599
—
NM
01
—
S0014741010
HCH ADMINISTRATION
NM
Enumeration date
12/07/2005
Last updated
09/15/2010
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