=====================================================
General NPI Number Information
=====================================================
NPI Number | 1023192598
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALAN S LAMMEY DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 E CENTER ST
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06040-5211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-649-7222
-----------------------------------------------------
Fax | 860-649-1219
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 315 E CENTER ST
-----------------------------------------------------
City | MANCHESTER
-----------------------------------------------------
State | CT
-----------------------------------------------------
Zip | 06040-5211
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 860-649-7222
-----------------------------------------------------
Fax | 860-649-1219
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223X0400X
-----------------------------------------------------
Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
-----------------------------------------------------
License Number | 004401
-----------------------------------------------------
License Number State | CT
-----------------------------------------------------