Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | S7-66C | NV |
NPI | 1053566703 |
---|---|
Provider Name | Dr. Ronald Ray Lemon |
First Address | Las Vegas, NV 89106-4124 |
Second Address | Las Vegas, NV 89102-2335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2008 |
Last Update Date | 21/11/2008 |