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General NPI Number Information
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NPI Number | 1407403769
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Entity Type | Individual
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Provider Name | ALYSSA NELL LAMBERT DDS
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Gender | Female
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Dates
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Enumeration Date | 08/21/2019
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 2415 PRINCE ST STE 105
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City | CONWAY
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State | AR
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Zip | 72034-3718
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Country | US
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Telephone | 501-328-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 600 S FRONT ST APT 101
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City | MEMPHIS
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State | TN
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Zip | 38103-1655
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Country | US
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Telephone | 901-412-5423
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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 | 4376
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License Number State | AR
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