Provider Demographics
NPI:1013365808
Name:PINNACLE ORAL SURGERY
Entity Type:Organization
Organization Name:PINNACLE ORAL SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL AND MAXILLOFACIAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MD
Authorized Official - Phone:570-586-5300
Mailing Address - Street 1:233 NORTHERN BLVD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:SOUTH ABINGTON TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-8720
Mailing Address - Country:US
Mailing Address - Phone:570-586-5300
Mailing Address - Fax:
Practice Address - Street 1:233 NORTHERN BLVD
Practice Address - Street 2:SUITE 5
Practice Address - City:SOUTH ABINGTON TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18411-8720
Practice Address - Country:US
Practice Address - Phone:570-586-5300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-02
Last Update Date:2016-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0369701223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty