Provider Demographics
NPI:1083762363
Name:LYNN, EVAN ASHLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:EVAN
Middle Name:ASHLEY
Last Name:LYNN
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:160 E 38TH ST
Mailing Address - Street 2:APT 25B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-2651
Mailing Address - Country:US
Mailing Address - Phone:631-786-0183
Mailing Address - Fax:646-649-3598
Practice Address - Street 1:999 WALT WHITMAN RD
Practice Address - Street 2:SUITE 302
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-3007
Practice Address - Country:US
Practice Address - Phone:631-358-9400
Practice Address - Fax:631-358-9421
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0496221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics