Provider Demographics
NPI:1669423984
Name:LYNN, STEVEN E (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:LYNN
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 1:2920 MCINTIRE DR.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-4213
Mailing Address - Country:US
Mailing Address - Phone:812-323-8112
Mailing Address - Fax:
Practice Address - Street 1:2920 MCINTYRE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47403-4221
Practice Address - Country:US
Practice Address - Phone:812-323-8112
Practice Address - Fax:812-323-8113
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12007261A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist