Provider Demographics
NPI:1184641789
Name:LYNN, JAMES JOSEPH (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOSEPH
Last Name:LYNN
Suffix:
Gender:M
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:PO BOX 1054
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29641
Mailing Address - Country:US
Mailing Address - Phone:864-269-0600
Mailing Address - Fax:864-269-0619
Practice Address - Street 1:105 SHERINGHAM DRIVE
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29642-3334
Practice Address - Country:US
Practice Address - Phone:864-269-0600
Practice Address - Fax:864-269-0619
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2014-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice