MEDICARE: ERIC L LIN DDS DENTAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	56553	CA

General Provider Information

NPI Number	:	1124318662
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERIC L LIN DDS DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	4181 REDONDO BEACH BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3340
Country	:	US
Telephone Number	:	310-371-6513
Fax Number	:

Provider Business Practice Location Address
First Line	:	4181 REDONDO BEACH BLVD
Second Line	:
City	:	LAWNDALE
State	:	CA
Zip	:	90260-3340
Country	:	US
Telephone Number	:	310-371-6513
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ERIC L LIN
Credential	:	D.D.S.
Telephone Number	:	310-527-2934

Provider Enumeration Date	:	04/18/2011
Last Update Date	:	04/18/2011

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