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General NPI Number Information
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NPI Number | 1821372301
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Entity Type | Individual
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Provider Name | LYNN DELL BODE D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 10/03/2011
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Last Update Date | 01/23/2020
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Provider Practice Location Address
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Address Line | 2000 NATIONAL RD W
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City | RICHMOND
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State | IN
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Zip | 47374-3854
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Country | US
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Telephone | 765-488-1072
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Fax | 765-381-1031
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Provider Business Mailing Address
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Address Line | 2000 NATIONAL RD W
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City | RICHMOND
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State | IN
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Zip | 47374-3854
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Country | US
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Telephone | 765-488-1072
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Fax | 765-381-1031
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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 | 12011792A
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License Number State | IN
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