Provider Demographics
NPI:1659964922
Name:LINCOLN DENTAL ARTS LLC
Entity Type:Organization
Organization Name:LINCOLN DENTAL ARTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIS
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:BARTH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:785-342-3430
Mailing Address - Street 1:130 E LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:KS
Mailing Address - Zip Code:67455-2051
Mailing Address - Country:US
Mailing Address - Phone:785-524-4441
Mailing Address - Fax:785-524-4441
Practice Address - Street 1:130 E LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:KS
Practice Address - Zip Code:67455-2051
Practice Address - Country:US
Practice Address - Phone:785-524-4441
Practice Address - Fax:785-524-4441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental