MEDICARE: DR. VERNON WILLIAM LIND JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	060034290	NC

General Provider Information

NPI Number	:	1164526794
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VERNON WILLIAM LIND JR. DDS

Provider Business Mailing Address
First Line	:	447 S SHARON AMITY RD
Second Line	:	STE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-2836
Country	:	US
Telephone Number	:	704-362-0000
Fax Number	:	704-362-4111

Provider Business Practice Location Address
First Line	:	447 S SHARON AMITY RD
Second Line	:	STE 100
City	:	CHARLOTTE
State	:	NC
Zip	:	28211-2836
Country	:	US
Telephone Number	:	704-362-0000
Fax Number	:	704-362-4111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	05/09/2013

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