Healthcare Provider Details

I. General information

NPI: 1255361424
Provider Name (Legal Business Name): LYNN DENTAL HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 KIRTLAND ST LYNN DENTAL HEALTH
LYNN MA
01905-1821
US

IV. Provider business mailing address

10 KIRTLAND ST LYNN DENTAL HEALTH
LYNN MA
01905-1821
US

V. Phone/Fax

Practice location:
  • Phone: 781-595-2552
  • Fax: 781-593-0730
Mailing address:
  • Phone: 781-595-2552
  • Fax: 781-593-0730

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JEYASRI GUNARAJASINGAM
Title or Position: OWNER DENTIST
Credential: DMD
Phone: 781-595-2552