Provider Demographics
NPI:1467888412
Name:LIN, ROBERT L (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:LIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20410 TOWN CENTER LN
Mailing Address - Street 2:SUITE 190
Mailing Address - City:CUPERTINO
Mailing Address - State:CA
Mailing Address - Zip Code:95014-3229
Mailing Address - Country:US
Mailing Address - Phone:215-316-1425
Mailing Address - Fax:
Practice Address - Street 1:2133 STOCKTON ST
Practice Address - Street 2:APT A106
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-2094
Practice Address - Country:US
Practice Address - Phone:215-316-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-23
Last Update Date:2013-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA629341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice