Provider Demographics
NPI:1497733950
Name:WELLMAN, LYNN M (DDS)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:M
Last Name:WELLMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 E WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1238
Mailing Address - Country:US
Mailing Address - Phone:330-773-7282
Mailing Address - Fax:330-773-7114
Practice Address - Street 1:275 E WATERLOO RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1238
Practice Address - Country:US
Practice Address - Phone:330-773-7282
Practice Address - Fax:330-773-7114
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300183021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice