Provider Demographics
NPI:1730360223
Name:BRYSON D. LEMONE, DDS, LLC
Entity type:Organization
Organization Name:BRYSON D. LEMONE, DDS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRYSON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LEMONE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:702-364-0044
Mailing Address - Street 1:8954 SPANISH RIDGE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1302
Mailing Address - Country:US
Mailing Address - Phone:702-364-0044
Mailing Address - Fax:702-364-0022
Practice Address - Street 1:8954 SPANISH RIDGE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89148-1302
Practice Address - Country:US
Practice Address - Phone:702-364-0044
Practice Address - Fax:702-364-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4796122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty