DR. Lisa Ely Wadsworth, D.M.D.

NPI #1508070707 in Lady Lake, Florida

Provider Information

NPI Number: 1508070707
Entity Type: Individual
Name: DR. Lisa Ely Wadsworth, D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: May 9, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 13940 N US HIGHWAY 441
Address 2: SUITE 602
City: Lady Lake
State: Florida
ZIP Code: 32159-8908
Phone: (352) 750-0008

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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