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General NPI Number Information
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NPI Number | 1477153526
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Entity Type | Organization
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Legal Business Name | BRIAN LYNGAAS, DDS, PLLC
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Dates
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Enumeration Date | 10/28/2020
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 18518 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3232
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Country | US
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Telephone | 248-473-0050
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Fax | 248-473-7490
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Provider Business Mailing Address
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Address Line | 18518 FARMINGTON RD
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City | LIVONIA
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State | MI
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Zip | 48152-3232
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Country | US
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Telephone | 248-473-0050
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Fax | 248-473-7490
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | DENISE M OBRIEN
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Credential |
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Telephone | 131-377-2539
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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