| Thomas J Lyle Dds Pc | |
|
2707 Easton Blvd Des Moines IA 50317-6123 | |
| (515) 265-0339 | |
| (515) 265-0339 |
| Full Name | Thomas J Lyle Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 2707 Easton Blvd, Des Moines, Iowa |
| Authorized Official Name and Position | Thomas James Lyle (PRESIDENT) |
| Authorized Official Contact | 5152650339 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas J Lyle Dds Pc 2707 Easton Blvd Des Moines IA 50317-6123 Ph: (515) 265-0339 | Thomas J Lyle Dds Pc 2707 Easton Blvd Des Moines IA 50317-6123 Ph: (515) 265-0339 |
| NPI Number | 1376700260 |
|---|---|
| Provider Enumeration Date | 05/19/2008 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376700260 | NPI | - | NPPES |
| 0195958 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 06797 (Iowa) | Primary |
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