MEDICARE: DR. LAP LAM D.M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	6447	NV

General Provider Information

NPI Number	:	1144662529
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LAP LAM D.M.D.

Provider Business Mailing Address
First Line	:	3417 S JONES BLVD
Second Line	:	SUITE F
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6784
Country	:	US
Telephone Number	:	702-257-6767
Fax Number	:	702-257-6722

Provider Business Practice Location Address
First Line	:	3417 S JONES BLVD
Second Line	:	SUITE F
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-6784
Country	:	US
Telephone Number	:	702-257-6767
Fax Number	:	702-257-6722

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2013
Last Update Date	:	09/11/2013

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