Provider Demographics
NPI:1043356900
Name:LIN, RICHARD HD JR (DMD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HD
Last Name:LIN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
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Mailing Address - Street 1:1432 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4710
Mailing Address - Country:US
Mailing Address - Phone:847-475-9220
Mailing Address - Fax:847-475-9223
Practice Address - Street 1:205 N MICHIGAN AVE
Practice Address - Street 2:SUITE 2214
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-5927
Practice Address - Country:US
Practice Address - Phone:312-819-1460
Practice Address - Fax:312-819-1491
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice