Provider Demographics
NPI:1164526794
Name:LIND, VERNON WILLIAM JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:WILLIAM
Last Name:LIND
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:447 S SHARON AMITY RD
Mailing Address - Street 2:STE 100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28211-2836
Mailing Address - Country:US
Mailing Address - Phone:704-362-0000
Mailing Address - Fax:704-362-4111
Practice Address - Street 1:447 S SHARON AMITY RD
Practice Address - Street 2:STE 100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-2836
Practice Address - Country:US
Practice Address - Phone:704-362-0000
Practice Address - Fax:704-362-4111
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-12
Last Update Date:2013-05-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0600342901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice