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Individual
DR. JAMES WYATT LINES
Active
Individual
DR. JAMES WYATT LINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
DD4398
NM
1223G0001X
General Practice Dentistry
Primary
8803
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26551322
—
NM
Enumeration date
10/03/2013
Last updated
03/25/2022
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