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General NPI Number Information
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NPI Number | 1225386246
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Entity Type | Individual
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Provider Name | DANIELLE LAM DDS
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Gender | Female
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Dates
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Enumeration Date | 08/23/2012
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 320 BRISTOL ST SUITE H
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City | COSTA MESA
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State | CA
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Zip | 92626-7946
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Country | US
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Telephone | 714-546-7595
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12211
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City | WESTMINSTER
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State | CA
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Zip | 92685-2211
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 61466
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License Number State | CA
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