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General NPI Number Information
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NPI Number | 1427262526
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Entity Type | Organization
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Legal Business Name | VILLAGE PLAZA DENTAL
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Dates
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Enumeration Date | 05/09/2007
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Last Update Date | 06/26/2008
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Provider Practice Location Address
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Address Line | 4750 VILLAGE PLAZA LOOP #201
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City | EUGENE
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State | OR
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Zip | 97401-6601
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Country | US
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Telephone | 541-343-3822
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Fax | 541-343-3824
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Provider Business Mailing Address
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Address Line | 4750 VILLAGE PLAZA LOOP #201
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City | EUGENE
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State | OR
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Zip | 97401-6601
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Country | US
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Telephone | 541-343-3822
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Fax | 541-343-3824
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAY C LAMB
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Credential | DMD
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Telephone | 541-343-3822
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 5637
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License Number State | OR
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