Provider Demographics
NPI:1881857241
Name:LYNCH, SEAN ANDREW (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:ANDREW
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 2ND ST SW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4944
Mailing Address - Country:US
Mailing Address - Phone:540-343-5521
Mailing Address - Fax:
Practice Address - Street 1:1315 2ND ST SW
Practice Address - Street 2:SUITE 100
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4944
Practice Address - Country:US
Practice Address - Phone:540-343-5521
Practice Address - Fax:540-343-0923
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist