Provider Demographics
NPI:1699004275
Name:LIN, PAUL E (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:E
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 1:234 PACA ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2820
Mailing Address - Country:US
Mailing Address - Phone:301-722-6130
Mailing Address - Fax:301-722-6133
Practice Address - Street 1:234 PACA ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2820
Practice Address - Country:US
Practice Address - Phone:301-722-6130
Practice Address - Fax:301-722-6133
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-10
Last Update Date:2009-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10345122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist