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General NPI Number Information
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NPI Number | 1306058110
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Entity Type | Organization
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Legal Business Name | AMITABHA LALA DDS PH.D
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 517 ROGERS ST
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City | LOWELL
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State | MA
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Zip | 01852-3826
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Country | US
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Telephone | 978-454-0977
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Fax | 978-458-8776
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Provider Business Mailing Address
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Address Line | 517 ROGERS ST
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City | LOWELL
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State | MA
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Zip | 01852-3826
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Country | US
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Telephone | 978-454-0977
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Fax | 978-458-8776
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Authorized Official
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Title or Position | ORTHODONTIST
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Name | DR. AMIT LALA
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Credential | DDS PHD
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Telephone | 978-454-0977
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 20359
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License Number State | MA
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