Provider Demographics
NPI:1376017434
Name:DOUGLAS LIN, DDS, INC
Entity Type:Organization
Organization Name:DOUGLAS LIN, DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-634-4040
Mailing Address - Street 1:3120 BALFOUR RD STE D
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5514
Mailing Address - Country:US
Mailing Address - Phone:925-634-4040
Mailing Address - Fax:
Practice Address - Street 1:3120 BALFOUR RD STE D
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-5514
Practice Address - Country:US
Practice Address - Phone:925-634-4040
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DOUGLAS LIN DDS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-11
Last Update Date:2019-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty