Healthcare Provider Details

I. General information

NPI: 1699828483
Provider Name (Legal Business Name): ROBERT LOUIS LAMB D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 05/17/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

GERMANY DHA-RP, CMR 402, UNIT 33100
APO AE
09180
US

IV. Provider business mailing address

GERMANY DHA-RP, CMR 402, UNIT 33100
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-1515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number7540
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: