Provider Demographics
NPI:1609976307
Name:LIN, WILLIAM W (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:W
Last Name:LIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5405 BALDWIN AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2625
Mailing Address - Country:US
Mailing Address - Phone:626-282-4548
Mailing Address - Fax:626-872-2571
Practice Address - Street 1:5405 BALDWIN AVE.
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2625
Practice Address - Country:US
Practice Address - Phone:626-282-4548
Practice Address - Fax:626-872-2571
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB383201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice