Provider Demographics
NPI:1043314768
Name:DRIZEN, LYNNE TAYLOR (DMD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:TAYLOR
Last Name:DRIZEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 282
Mailing Address - Street 2:8-10 MARTIN STREET
Mailing Address - City:ESSEX
Mailing Address - State:MA
Mailing Address - Zip Code:01929-1216
Mailing Address - Country:US
Mailing Address - Phone:978-768-1166
Mailing Address - Fax:978-768-9016
Practice Address - Street 1:8-10 MARTIN STREET
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MA
Practice Address - Zip Code:01929-1216
Practice Address - Country:US
Practice Address - Phone:978-768-1166
Practice Address - Fax:978-768-9016
Is Sole Proprietor?:No
Enumeration Date:2006-09-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA183061223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics