Individual
JOHN ANTHONY LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3053 FREEDOM DR STE B, CHARLOTTE, NC 28208-3862
(704) 393-3911
(704) 392-1096
Mailing address
2041 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-5147
(336) 777-0303
(336) 777-3448
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7457
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
89-902E3
—
NC
01
—
902E3
BLUE CROSS BLUE SHIELD NC
—
Enumeration date
08/25/2006
Last updated
02/05/2008
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