Provider Demographics
NPI:1598087603
Name:KARL E. LIND DDS, INC
Entity Type:Organization
Organization Name:KARL E. LIND DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:E
Authorized Official - Last Name:LIND
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:801-262-7447
Mailing Address - Street 1:3920 S 1100 E
Mailing Address - Street 2:STE 150
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84124-1213
Mailing Address - Country:US
Mailing Address - Phone:801-262-7447
Mailing Address - Fax:801-262-7450
Practice Address - Street 1:3920 S 1100 E
Practice Address - Street 2:STE 150
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84124-1213
Practice Address - Country:US
Practice Address - Phone:801-262-7447
Practice Address - Fax:801-262-7450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-17
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT13284899241223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT000001927Medicare PIN
UTT89126Medicare UPIN