Healthcare Provider Details

I. General information

NPI: 1437148178
Provider Name (Legal Business Name): GARY SCOTT LINDNER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/16/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

72 S RIVER RD
BEDFORD NH
03110-6709
US

IV. Provider business mailing address

72 S RIVER RD
BEDFORD NH
03110-6709
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-3900
  • Fax: 603-624-0030
Mailing address:
  • Phone: 603-624-3900
  • Fax: 603-624-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number1837
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: