Provider Demographics
NPI:1316506686
Name:NOONAN, LYNN MARIE (RDH)
Entity type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MARIE
Last Name:NOONAN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69V ISLAND STREET
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:NH
Mailing Address - Zip Code:03431
Mailing Address - Country:US
Mailing Address - Phone:603-358-6624
Mailing Address - Fax:603-358-6641
Practice Address - Street 1:69V ISLAND STREET
Practice Address - Street 2:
Practice Address - City:KEENE
Practice Address - State:NH
Practice Address - Zip Code:03431
Practice Address - Country:US
Practice Address - Phone:603-358-6624
Practice Address - Fax:603-358-6641
Is Sole Proprietor?:No
Enumeration Date:2019-06-11
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH00683124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist