Provider Demographics
NPI:1053316760
Name:TAICLET, LYNNE MARIE (DMD)
Entity Type:Individual
Prefix:DR
First Name:LYNNE
Middle Name:MARIE
Last Name:TAICLET
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 1:1712 MOUNT NEBO RD
Mailing Address - Street 2:STE 103
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8526
Mailing Address - Country:US
Mailing Address - Phone:412-741-3337
Mailing Address - Fax:412-741-8977
Practice Address - Street 1:1712 MOUNT NEBO RD
Practice Address - Street 2:STE 103
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8526
Practice Address - Country:US
Practice Address - Phone:412-741-3337
Practice Address - Fax:412-741-8977
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025067-L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice