Provider Demographics
NPI:1497964068
Name:EDWARD J. LYNCH, DDS, PC
Entity Type:Organization
Organization Name:EDWARD J. LYNCH, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:605-343-5925
Mailing Address - Street 1:2220 5TH ST
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-5428
Mailing Address - Country:US
Mailing Address - Phone:605-343-5925
Mailing Address - Fax:605-399-2555
Practice Address - Street 1:2220 5TH ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-5428
Practice Address - Country:US
Practice Address - Phone:605-343-5925
Practice Address - Fax:605-399-2555
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
SD=========OtherTAX ID NUMBER