Healthcare Provider Details

I. General information

NPI: 1376513184
Provider Name (Legal Business Name): DAVID A. LAMOT D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 MAIN ST SUITE 2
WILLIMANTIC CT
06226-1948
US

IV. Provider business mailing address

1315 MAIN ST SUITE 2
WILLIMANTIC CT
06226-1948
US

V. Phone/Fax

Practice location:
  • Phone: 860-450-7471
  • Fax: 860-423-4629
Mailing address:
  • Phone: 860-450-7471
  • Fax: 860-423-4629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number007273
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: