Provider Demographics
NPI:1477571602
Name:BRISLIN, LINDSAY CIOMBOR (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:CIOMBOR
Last Name:BRISLIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 FRONT ST
Mailing Address - Street 2:B201
Mailing Address - City:CUMBERLAND
Mailing Address - State:RI
Mailing Address - Zip Code:02864-4847
Mailing Address - Country:US
Mailing Address - Phone:508-942-6544
Mailing Address - Fax:
Practice Address - Street 1:536 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-1947
Practice Address - Country:US
Practice Address - Phone:401-726-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDEN02935122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist