Healthcare Provider Details

I. General information

NPI: 1689866477
Provider Name (Legal Business Name): LAMBERT DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2007
Last Update Date: 08/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6480 HWY 11 NORTH
CARRIERE MS
39426
US

IV. Provider business mailing address

6480 HWY 11 NORTH
CARRIERE MS
39426
US

V. Phone/Fax

Practice location:
  • Phone: 601-749-9330
  • Fax: 601-749-9449
Mailing address:
  • Phone: 601-749-9330
  • Fax: 601-749-9449

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number3007
License Number StateMS

VIII. Authorized Official

Name: DR. JAMES LEWIS LAMBERT
Title or Position: DDS OWNER
Credential:
Phone: 601-749-9330