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Michael Lysonski Dds Llc
General Practice Dentistry in Edgewood, New Mexico
NPI 1427513902

Michael Lysonski Dds Llc is a General Practice Dentistry based in Albuquerque, NM and is specialized in General Practice. Michael Lysonski Dds Llc practices in Edgewood, NM. The NPI Number for Michael Lysonski Dds Llc is 1427513902 and holds a License No. (New Mexico).

The current practice location address for Michael Lysonski Dds Llc is 1917 Old Us 66, Edgewood, NM and can be reached out via phone at 262-391-6179.

Location: 1917 Old Us 66, Edgewood, NM, 87123-4412
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1427513902
Provider Name
Michael Lysonski Dds Llc
Credential
Provider Entity Type
Organization
Address
1917 Old Us 66, Edgewood, NM, 87123-4412
Phone Number
262-391-6179
Fax Number
Provider Enumeration Date
02/08/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
17933030 05 NM
DD4113 01 NM NM DENTAL LICENSE
03-426588-00-0 01 NM NMCRS
CS00220539 01 NM NM CONTROLLED SUBSTANCE
institution
Provider Business Practice Location Address Details
Address
1917 Old Us 66
City
Edgewood
State
New Mexico
Zip
87015-6799
Phone Number
262-391-6179
Fax Number
person
Provider Business Mailing Address Details
Address
1917 Old Us 66
City
Edgewood
State
New Mexico
Zip
87015-6799
Phone Number
262-391-6179
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
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Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
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