Healthcare Provider Details
I. General information
NPI: 1821185638
Provider Name (Legal Business Name): JOSEPH LYNCH DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
320 S MAIN ST
PHILLIPSBURG NJ
08865
US
IV. Provider business mailing address
320 SOUTH MAIN STREET C/O DENTIST DENTAL HEALTH ASSOCIATES PA CORPORATE OFFICE 2ND FLOOR
PHILLIPSBURG NJ
08865
US
V. Phone/Fax
- Phone: 908-454-9800
- Fax: 908-454-1351
- Phone: 908-387-6120
- Fax: 908-387-8322
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223X0400X |
| Taxonomy | Orthodontics and Dentofacial Orthopedics Dentistry |
| License Number | DI06998 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: