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DR. JEFFREY LYSDALE D.D.S.

>> Dentist >> Dental Providers

Registrant NPI Number: 1083825004

Individual Registrant:
DR. JEFFREY  LYSDALE D.D.S.
Gender: M
Sole Proprietor

Location and contact information for practice:
2311 S CASINO DR STE D  LAUGHLIN, NV 89029-1534 US
Tel: 702-298-4545  Fax: --

Contact information for business:
1830 KIRK DRIVE  LAKE HAVASU CITY, AZ 86404 US
Tel: 949-351-7343  Fax: --

Registration Information:
NPI: 1083825004
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
NV4186

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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