Provider Demographics
NPI:1275187791
Name:LIN DENTAL CORP
Entity Type:Organization
Organization Name:LIN DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KING
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:714-758-7777
Mailing Address - Street 1:10600 KATELLA AVE
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92804-6607
Mailing Address - Country:US
Mailing Address - Phone:714-758-7777
Mailing Address - Fax:
Practice Address - Street 1:10600 KATELLA AVE
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92804-6607
Practice Address - Country:US
Practice Address - Phone:714-758-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-01
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty