Provider Demographics
NPI:1538152806
Name:LYNCH, THOMAS JAMES (DDS)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1675 BRIARGATE BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3452
Mailing Address - Country:US
Mailing Address - Phone:719-598-7797
Mailing Address - Fax:719-598-7077
Practice Address - Street 1:1675 BRIARGATE BLVD
Practice Address - Street 2:STE C
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3452
Practice Address - Country:US
Practice Address - Phone:719-598-7797
Practice Address - Fax:719-598-7077
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO71391223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics