Provider Demographics
NPI:1942744289
Name:WOOD, LYNDSAY (LD)
Entity Type:Individual
Prefix:MRS
First Name:LYNDSAY
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 549
Mailing Address - Street 2:7 GRETCHEN LANE
Mailing Address - City:STANDISH
Mailing Address - State:ME
Mailing Address - Zip Code:04084
Mailing Address - Country:US
Mailing Address - Phone:207-642-2310
Mailing Address - Fax:207-642-6815
Practice Address - Street 1:7 GRETCHEN LANE
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:ME
Practice Address - Zip Code:04084
Practice Address - Country:US
Practice Address - Phone:207-642-2310
Practice Address - Fax:207-642-6815
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEDTR5534122400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist