Provider Demographics
NPI:1790198828
Name:LYNCH, DAWN (RDH)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:LYNCH
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:DAWN
Other - Last Name:LYNCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RDH
Mailing Address - Street 1:PO BOX 265
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-0265
Mailing Address - Country:US
Mailing Address - Phone:229-251-3087
Mailing Address - Fax:
Practice Address - Street 1:17 MIDLAND DR
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1914
Practice Address - Country:US
Practice Address - Phone:607-334-5366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027844124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist