Provider Demographics
NPI:1952918278
Name:LINCOLN DENTAL ARTS, PLLC
Entity Type:Organization
Organization Name:LINCOLN DENTAL ARTS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:HILDENBRAND
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:662-321-5883
Mailing Address - Street 1:PO BOX 416
Mailing Address - Street 2:
Mailing Address - City:SALTILLO
Mailing Address - State:MS
Mailing Address - Zip Code:38866-0416
Mailing Address - Country:US
Mailing Address - Phone:601-255-2599
Mailing Address - Fax:
Practice Address - Street 1:4301 LINCOLN RD # 20
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-3036
Practice Address - Country:US
Practice Address - Phone:601-255-2599
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty