Provider Demographics
NPI:1881797967
Name:LIN, CHI TAW (DMD)
Entity type:Individual
Prefix:
First Name:CHI TAW
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:C
Other - Last Name:LIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:403 OMNI DR ROUTE 206
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NJ
Mailing Address - Zip Code:08844
Mailing Address - Country:US
Mailing Address - Phone:908-359-5243
Mailing Address - Fax:
Practice Address - Street 1:403 OMNI DR ROUTE 206
Practice Address - Street 2:PROFESSIONAL CENTER AT HILLSBOROUGH
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844
Practice Address - Country:US
Practice Address - Phone:908-359-5243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNJ147721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice