Provider Demographics
NPI:1285853200
Name:MCDERMOTT, LYNDI KAYE (RDH)
Entity Type:Individual
Prefix:MS
First Name:LYNDI
Middle Name:KAYE
Last Name:MCDERMOTT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 YAMPA AVE
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2609
Mailing Address - Country:US
Mailing Address - Phone:970-824-8000
Mailing Address - Fax:970-824-1179
Practice Address - Street 1:485 YAMPA AVE
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2609
Practice Address - Country:US
Practice Address - Phone:970-824-8000
Practice Address - Fax:970-824-1179
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO904708124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist