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General NPI Number Information
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NPI Number | 1790205441
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Entity Type | Organization
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Legal Business Name | LAMB DENTAL SERVICES
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Dates
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Enumeration Date | 06/23/2017
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Last Update Date | 06/26/2017
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Provider Practice Location Address
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Address Line | 2700 S UNIVERSITY DR
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City | MIRAMAR
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State | FL
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Zip | 33025-3015
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Country | US
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Telephone | 954-283-7085
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Fax | 954-252-2306
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Provider Business Mailing Address
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Address Line | 4747 SW 39TH AVE
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City | FORT LAUDERDALE
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State | FL
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Zip | 33312-5450
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Country | US
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Telephone | 954-907-0271
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Fax | 954-252-2306
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Authorized Official
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Title or Position | OWNER
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Name | DR. NICOLE L LAMB
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Credential | DMD
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Telephone | 954-283-7085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DN20725
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License Number State | FL
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