Provider Demographics
NPI:1679688733
Name:LYNCH, COLLEEN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:COLLEEN
Middle Name:A
Last Name:LYNCH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:COLLEEN
Other - Middle Name:A
Other - Last Name:LYNCH DEAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2 MORSE POND CT
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-4318
Mailing Address - Country:US
Mailing Address - Phone:508-498-6992
Mailing Address - Fax:
Practice Address - Street 1:1300 UNION ST # G101
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-5416
Practice Address - Country:US
Practice Address - Phone:508-366-3623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA177681223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice