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General NPI Number Information
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NPI Number | 1780290635
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Entity Type | Organization
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Legal Business Name | VITAL DENTAL SPECIALISTS, INC.
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 3965 S REGIONAL ST
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City | TERRE HAUTE
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State | IN
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Zip | 47802-5505
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Country | US
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Telephone | 812-235-1598
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Fax |
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Provider Business Mailing Address
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Address Line | 311 HERITAGE LN E
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City | TERRE HAUTE
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State | IN
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Zip | 47803-1371
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Country | US
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Telephone | 719-332-1173
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ZANE LAMBERT
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Credential | DMD
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Telephone | 719-332-1173
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number |
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License Number State |
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