Provider Demographics
NPI:1548464761
Name:LYNCH, GEORGE THOMAS IV (DMD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:THOMAS
Last Name:LYNCH
Suffix:IV
Gender:M
Credentials:DMD
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Mailing Address - Street 1:1101 WASHINGTON AVE
Mailing Address - Street 2:V1
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19147-3839
Mailing Address - Country:US
Mailing Address - Phone:267-909-9551
Mailing Address - Fax:267-909-9761
Practice Address - Street 1:1352 SOUTH ST
Practice Address - Street 2:C5
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1858
Practice Address - Country:US
Practice Address - Phone:267-909-9551
Practice Address - Fax:267-909-9761
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2011-03-29
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Provider Licenses
StateLicense IDTaxonomies
NJ23427001223P0221X
PADS0367871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry