Provider Demographics
NPI:1902964018
Name:LYERLY & ASSOCIATES DDS PA
Entity Type:Organization
Organization Name:LYERLY & ASSOCIATES DDS PA
Other - Org Name:EZ DENTAL CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT LYERLY & ASSOCIATES DDS P
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:LYERLY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:704-279-5400
Mailing Address - Street 1:PO BOX 328
Mailing Address - Street 2:
Mailing Address - City:GRANITE QUARRY
Mailing Address - State:NC
Mailing Address - Zip Code:28072-0328
Mailing Address - Country:US
Mailing Address - Phone:704-279-5400
Mailing Address - Fax:704-279-2476
Practice Address - Street 1:5980 US HWY 52
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:NC
Practice Address - Zip Code:28146-8138
Practice Address - Country:US
Practice Address - Phone:704-279-5400
Practice Address - Fax:704-279-2476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3070122300000X
NC7537122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty