Provider Demographics
NPI:1407942964
Name:LINS, DOUGLAS W (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:W
Last Name:LINS
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 1:917 SAN RAMON VALLEY BOULEVARD, SUITE 290
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-4032
Mailing Address - Country:US
Mailing Address - Phone:925-837-9172
Mailing Address - Fax:925-837-9147
Practice Address - Street 1:917 SAN RAMON VALLEY BOULEVARD, SUITE 290
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-4032
Practice Address - Country:US
Practice Address - Phone:925-837-9172
Practice Address - Fax:925-837-9147
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA275371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice