Individual
IVY LIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6059 BOYLSTON DR STE 150, SANDY SPRINGS, GA 30328-4175
(651) 494-4167
Mailing address
2651 SATELLITE BLVD APT 9012, DULUTH, GA 30096-1168
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN124183
GA
122300000X
Dentist
DN29078
FL
Other
Enumeration date
06/14/2024
Last updated
08/05/2026
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