Provider Demographics
NPI:1164725321
Name:LYNNE GERLACH DENTAL
Entity Type:Organization
Organization Name:LYNNE GERLACH DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNE
Authorized Official - Middle Name:
Authorized Official - Last Name:GERLACH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:972-943-9300
Mailing Address - Street 1:5425 W SPRING CREEK PKWY
Mailing Address - Street 2:SUITE 165
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75024-4335
Mailing Address - Country:US
Mailing Address - Phone:972-943-9300
Mailing Address - Fax:972-943-9301
Practice Address - Street 1:5425 W SPRING CREEK PKWY
Practice Address - Street 2:SUITE 165
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-4335
Practice Address - Country:US
Practice Address - Phone:972-943-9300
Practice Address - Fax:972-943-9301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15499122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty