Provider Demographics
NPI:1811672942
Name:LINCOLN DENTAL CARE LLC
Entity type:Organization
Organization Name:LINCOLN DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ZORAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:401-724-2570
Mailing Address - Street 1:95 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-2518
Mailing Address - Country:US
Mailing Address - Phone:401-723-1750
Mailing Address - Fax:401-726-8660
Practice Address - Street 1:95 WALKER ST
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-2518
Practice Address - Country:US
Practice Address - Phone:401-723-1750
Practice Address - Fax:401-726-8660
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty