Provider Demographics
NPI:1093974685
Name:LINDSAY, JAMIE BRIAN
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:BRIAN
Last Name:LINDSAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:BRIAN
Other - Last Name:LINDSAY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:205 W WINDCREST ST
Mailing Address - Street 2:SUITE # 210
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78624-4479
Mailing Address - Country:US
Mailing Address - Phone:830-997-7232
Mailing Address - Fax:
Practice Address - Street 1:205 W WINDCREST ST
Practice Address - Street 2:SUITE # 210
Practice Address - City:FREDERICKSBURG
Practice Address - State:TX
Practice Address - Zip Code:78624-4479
Practice Address - Country:US
Practice Address - Phone:830-997-7232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239261223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice