Individual provider · Type 1 NPI

Susannah Elizabeth Lyddon, DMD

Student in an Organized Health Care Education/Training Program · Pontiac, MI

NPI number 1972161214 Active

Practice location

44405 Woodward Ave
Pontiac, MI 48341-5023

Call (248) 858-3234 Map

Mailing address

3386 Auburn Rd Apt 3205
Auburn Hills, MI 48326-3483

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1972161214

Susannah Elizabeth Lyddon, DMD's National Provider Identifier is 1972161214, issued on Jun 2, 2019. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Pontiac, MI. The record was last updated on Jun 2, 2019.