Provider Demographics
NPI:1750482006
Name:COTHRON, LYNN J (DMD)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:J
Last Name:COTHRON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MRS
Other - First Name:SARA
Other - Middle Name:LYNN
Other - Last Name:JACKSON-COTHRON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:PO BOX 236
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:TN
Mailing Address - Zip Code:37083
Mailing Address - Country:US
Mailing Address - Phone:615-666-5034
Mailing Address - Fax:615-666-8881
Practice Address - Street 1:1203 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:TN
Practice Address - Zip Code:37083
Practice Address - Country:US
Practice Address - Phone:615-666-5034
Practice Address - Fax:605-666-8881
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS0000007346122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist