Provider Demographics
NPI:1811417603
Name:TRINITY DENTAL PLLC
Entity Type:Organization
Organization Name:TRINITY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:LINDNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-434-1096
Mailing Address - Street 1:9497 N FORT WASHINGTON RD STE 106
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93730-0606
Mailing Address - Country:US
Mailing Address - Phone:559-434-1096
Mailing Address - Fax:559-434-1799
Practice Address - Street 1:1 HUNTINGTON AVE UNIT B
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-5713
Practice Address - Country:US
Practice Address - Phone:617-431-1383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1856782261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental