Provider Demographics
NPI:1669748364
Name:BRIAN C LIN DDS INC
Entity type:Organization
Organization Name:BRIAN C LIN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-662-1747
Mailing Address - Street 1:520 COTTONWOOD ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WOODLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95695-3603
Mailing Address - Country:US
Mailing Address - Phone:530-662-1747
Mailing Address - Fax:530-662-4206
Practice Address - Street 1:520 COTTONWOOD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:WOODLAND
Practice Address - State:CA
Practice Address - Zip Code:95695-3603
Practice Address - Country:US
Practice Address - Phone:530-662-1747
Practice Address - Fax:530-662-4206
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-27
Last Update Date:2012-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA57292122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty