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General NPI Number Information
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NPI Number | 1548615586
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Entity Type | Organization
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Legal Business Name | MILLTOWN FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 04/27/2016
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Provider Practice Location Address
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Address Line | 310 E MAIN ST SUITE 335
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City | CARRBORO
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State | NC
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Zip | 27510-2312
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Country | US
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Telephone | 919-590-5450
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Fax |
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Provider Business Mailing Address
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Address Line | 310 E MAIN ST SUITE 335
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City | CARRBORO
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State | NC
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Zip | 27510-2312
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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 | MEMBER/ORGANIZER
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Name | DR. BENJAMIN LAMBETH
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Credential | D.D.S.
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Telephone | 919-606-7291
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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 | 9063
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License Number State | NC
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