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General NPI Number Information
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NPI Number | 1619132883
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Entity Type | Organization
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Legal Business Name | NICOLE P. LAM, LLC
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Dates
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Enumeration Date | 07/27/2008
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Last Update Date | 07/27/2008
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Provider Practice Location Address
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Address Line | 7277 SASHAYING SPIRIT CT
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City | LAS VEGAS
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State | NV
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Zip | 89131-2356
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Country | US
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Telephone | 702-328-8349
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Fax |
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Provider Business Mailing Address
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Address Line | 7277 SASHAYING SPIRIT CT
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City | LAS VEGAS
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State | NV
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Zip | 89131-2356
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Country | US
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Telephone | 702-328-8349
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. NICOLE PHUONG LAM
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Credential | D.M.D.
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Telephone | 702-328-8349
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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 | 5730
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License Number State | NV
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