Individual
DR. LINC J CONN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MPH
Contact information
Practice address
600 MOYE BLVD, ECU SCHOOL OF DENTAL MEDICINE, GREENVILLE, NC 27834-4300
(252) 737-7024
(252) 737-7049
Mailing address
600 MOYE BLVD, ECU SCHOOL OF DENTAL MEDICINE, GREENVILLE, NC 27834-4300
(252) 737-7024
(252) 737-7049
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
15605
TX
1223G0001X
General Practice Dentistry
Primary
9224
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
090674501
—
TX
01
—
090674502
MEDICAID
TX
01
—
83Y605
BLUE CROSS BLUE SHIELD
—
01
—
87116
UNITED CONCORDIA
—
Enumeration date
10/12/2006
Last updated
02/14/2012
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