Provider Demographics
NPI:1265481360
Name:LYN, PATRICIA E (DMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:E
Last Name:LYN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11150 OKEECHOBEE BLVD
Mailing Address - Street 2:SUITE U
Mailing Address - City:ROYAL PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33411-1352
Mailing Address - Country:US
Mailing Address - Phone:561-790-7434
Mailing Address - Fax:561-790-7436
Practice Address - Street 1:11150 OKEECHOBEE BLVD
Practice Address - Street 2:SUITE U
Practice Address - City:ROYAL PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33411-1352
Practice Address - Country:US
Practice Address - Phone:561-790-7434
Practice Address - Fax:561-790-7436
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN12740122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist