Provider Demographics
NPI:1134188477
Name:LYNCH, PAUL R (DDS)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:R
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 1:6630 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-6837
Mailing Address - Country:US
Mailing Address - Phone:727-848-4495
Mailing Address - Fax:727-844-3085
Practice Address - Street 1:6630 RIDGE RD
Practice Address - Street 2:
Practice Address - City:PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34668-6837
Practice Address - Country:US
Practice Address - Phone:727-848-4495
Practice Address - Fax:727-844-3085
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL12351122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist