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General NPI Number Information
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NPI Number | 1780865162
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Entity Type | Organization
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Legal Business Name | JERRY E. LAMBERT, JR., D.D.S., P.C.
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Dates
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Enumeration Date | 11/14/2007
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Last Update Date | 11/14/2007
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Provider Practice Location Address
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Address Line | 301 S COURT ST
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City | CROWN POINT
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State | IN
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Zip | 46307-3960
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Country | US
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Telephone | 219-663-1207
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Fax | 219-663-6474
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Provider Business Mailing Address
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Address Line | 301 S COURT ST
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City | CROWN POINT
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State | IN
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Zip | 46307-3960
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Country | US
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Telephone | 219-663-1207
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Fax | 219-663-6474
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Authorized Official
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Title or Position | OWNER
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Name | DR. JERRY E. LAMBERT JR.
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Credential | D.D.S.
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Telephone | 219-663-1207
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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 | 54001561A
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License Number State | IN
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