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General NPI Number Information
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NPI Number | 1669748364
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Entity Type | Organization
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Legal Business Name | BRIAN C LIN DDS INC
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Dates
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Enumeration Date | 03/27/2012
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Last Update Date | 03/27/2012
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Provider Practice Location Address
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Address Line | 520 COTTONWOOD ST SUITE 1
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City | WOODLAND
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State | CA
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Zip | 95695-3603
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Country | US
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Telephone | 530-662-1747
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Fax | 530-662-4206
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Provider Business Mailing Address
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Address Line | 520 COTTONWOOD ST SUITE 1
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City | WOODLAND
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State | CA
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Zip | 95695-3603
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Country | US
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Telephone | 530-662-1747
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Fax | 530-662-4206
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRIAN C LIN
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Credential | DDS
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Telephone | 530-662-1747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 57292
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License Number State | CA
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