Individual
LISA IRISH DEESE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.M.D.
Contact information
Practice address
1100 F AVE, DOUGLAS, AZ 85607-1919
(520) 364-3285
(520) 364-3378
Mailing address
1100 F AVE, DOUGLAS, AZ 85607-1919
(520) 364-3285
(520) 364-4261
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D009122
AZ
1223G0001X
General Practice Dentistry
DN19100
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
192919
—
AZ
Enumeration date
05/18/2010
Last updated
05/01/2017
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