Provider Demographics
NPI:1932377579
Name:LIN, HOLLY MIAW-JANE (DDS)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:MIAW-JANE
Last Name:LIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13992 MERRIMAN RD
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-4259
Mailing Address - Country:US
Mailing Address - Phone:734-422-7525
Mailing Address - Fax:734-422-6921
Practice Address - Street 1:13992 MERRIMAN RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4259
Practice Address - Country:US
Practice Address - Phone:734-422-7525
Practice Address - Fax:734-422-6921
Is Sole Proprietor?:No
Enumeration Date:2008-02-18
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010164911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice