Healthcare Provider Details

I. General information

NPI: 1366410128
Provider Name (Legal Business Name): ROBERT A LINDINGER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

620 LEE ST
WINSLOW AZ
86047-2435
US

IV. Provider business mailing address

6125 E OLSON DR
FLAGSTAFF AZ
86004-7188
US

V. Phone/Fax

Practice location:
  • Phone: 928-289-2000
  • Fax: 928-213-6136
Mailing address:
  • Phone: 928-289-2000
  • Fax: 928-213-6136

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD2600
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: