Provider Demographics
NPI:1770690323
Name:JOHN T LINVOG
Entity Type:Organization
Organization Name:JOHN T LINVOG
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:LINVOG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-252-0311
Mailing Address - Street 1:3802 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4940
Mailing Address - Country:US
Mailing Address - Phone:425-252-0311
Mailing Address - Fax:425-303-8593
Practice Address - Street 1:3802 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4940
Practice Address - Country:US
Practice Address - Phone:425-252-0311
Practice Address - Fax:425-303-8593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA43671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty