Provider Demographics
NPI:1851411722
Name:WILLIAM E. LIN, D.D.S., A PUBLIC CORPORATION
Entity Type:Organization
Organization Name:WILLIAM E. LIN, D.D.S., A PUBLIC CORPORATION
Other - Org Name:SOUTHLAND PLAZA DENTAL OFFICE, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ESING
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:619-429-4030
Mailing Address - Street 1:655 SATURN BLVD
Mailing Address - Street 2:G
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92154-4734
Mailing Address - Country:US
Mailing Address - Phone:619-429-4030
Mailing Address - Fax:619-429-3710
Practice Address - Street 1:655 SATURN BLVD
Practice Address - Street 2:G
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92154-4734
Practice Address - Country:US
Practice Address - Phone:619-429-4030
Practice Address - Fax:619-429-3710
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36093261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental