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General NPI Number Information
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NPI Number | 1427510882
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Entity Type | Individual
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Provider Name | ERIC RYAN LINKOUS DDS
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Gender | Male
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Dates
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Enumeration Date | 04/04/2019
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Last Update Date | 04/04/2019
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Provider Practice Location Address
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Address Line | 268 S PEACHTREE PKWY
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-1700
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Country | US
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Telephone | 770-487-6439
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 RIVER BRIDGE CIR APT 304
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City | MEMPHIS
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State | TN
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Zip | 38103-7918
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Country | US
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Telephone | 423-839-3308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DN015801
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License Number State | GA
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