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General NPI Number Information
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NPI Number | 1700288792
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Entity Type | Individual
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Provider Name | RAMIRO LAMBARIA III D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/22/2014
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Last Update Date | 01/15/2024
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Provider Practice Location Address
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Address Line | 455 CHERRY ST SE STE 1
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-4658
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Country | US
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Telephone | 616-458-8593
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Fax |
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Provider Business Mailing Address
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Address Line | 5303 E CORTLAND BLVD APT K08
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-9580
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Country | US
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Telephone | 810-347-7117
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901021412
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License Number State | MI
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