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General NPI Number Information
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NPI Number | 1205258415
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Entity Type | Organization
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Legal Business Name | MAGGIE LAM PLLC
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Dates
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Enumeration Date | 01/08/2014
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 1761 E WARNER RD # A-14
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City | TEMPE
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State | AZ
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Zip | 85284-4558
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Country | US
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Telephone | 480-755-3320
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Fax | 480-755-0536
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Provider Business Mailing Address
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Address Line | 1761 E WARNER RD # A-14
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City | TEMPE
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State | AZ
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Zip | 85284-4558
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Country | US
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Telephone | 480-755-3320
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Fax | 480-755-0536
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. MAGGIE T LAM
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Credential | DDS
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Telephone | 480-755-3320
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305R00000X
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Taxonomy Name | Preferred Provider Organization
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License Number | 6178
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License Number State | AZ
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