Provider Demographics
NPI:1770640682
Name:LYNCH, DENNIS M (DC)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:M
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SWEET HOME
Mailing Address - State:OR
Mailing Address - Zip Code:97386
Mailing Address - Country:US
Mailing Address - Phone:541-367-6163
Mailing Address - Fax:541-367-1425
Practice Address - Street 1:920 MAIN ST
Practice Address - Street 2:
Practice Address - City:SWEET HOME
Practice Address - State:OR
Practice Address - Zip Code:97386
Practice Address - Country:US
Practice Address - Phone:541-367-6163
Practice Address - Fax:541-367-1425
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR272728111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR115195Medicare UPIN
R115194Medicare UPIN