Provider Demographics
NPI:1407909476
Name:LYNN, EDWARD ARTHUR (DDS)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:ARTHUR
Last Name:LYNN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:466 E CALAVERAS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-5453
Mailing Address - Country:US
Mailing Address - Phone:408-946-1823
Mailing Address - Fax:408-956-1110
Practice Address - Street 1:466 E CALAVERAS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5453
Practice Address - Country:US
Practice Address - Phone:408-946-1823
Practice Address - Fax:408-956-1110
Is Sole Proprietor?:No
Enumeration Date:2007-01-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADB0268871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice