Provider Demographics
NPI:1366053928
Name:CHAMBERLAIN, LINCOLN (DDS)
Entity type:Individual
Prefix:
First Name:LINCOLN
Middle Name:
Last Name:CHAMBERLAIN
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 1:376 STONEGATE
Mailing Address - Street 2:
Mailing Address - City:WIND GAP
Mailing Address - State:PA
Mailing Address - Zip Code:18091-9502
Mailing Address - Country:US
Mailing Address - Phone:610-216-5288
Mailing Address - Fax:
Practice Address - Street 1:118 S MAIN ST
Practice Address - Street 2:
Practice Address - City:NAZARETH
Practice Address - State:PA
Practice Address - Zip Code:18064-2044
Practice Address - Country:US
Practice Address - Phone:610-759-4323
Practice Address - Fax:610-365-2638
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0428761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice