Provider Demographics
NPI:1467507236
Name:LYNN, SUZANNE TEEL (DMD)
Entity type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:TEEL
Last Name:LYNN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-4204
Mailing Address - Country:US
Mailing Address - Phone:205-936-0492
Mailing Address - Fax:
Practice Address - Street 1:2323 MOODY PKWY
Practice Address - Street 2:
Practice Address - City:MOODY
Practice Address - State:AL
Practice Address - Zip Code:35004-3012
Practice Address - Country:US
Practice Address - Phone:205-640-1717
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5365122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist