Provider Demographics
NPI:1588228803
Name:LYNN DENTAL ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:LYNN DENTAL ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAKKOOM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-824-4916
Mailing Address - Street 1:232 UNION ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1315
Mailing Address - Country:US
Mailing Address - Phone:781-586-9500
Mailing Address - Fax:781-586-9520
Practice Address - Street 1:232 UNION ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1315
Practice Address - Country:US
Practice Address - Phone:781-586-9500
Practice Address - Fax:781-586-9520
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-23
Last Update Date:2019-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental