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General NPI Number Information
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NPI Number | 1942844998
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Entity Type | Organization
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Legal Business Name | COURTNEY J LAM DMD PLLC
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Dates
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Enumeration Date | 11/03/2019
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Last Update Date | 11/03/2019
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Provider Practice Location Address
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Address Line | 244 ADELIA ST
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City | MIDDLETOWN
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State | PA
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Zip | 17057-2711
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Country | US
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Telephone | 918-269-8517
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Fax |
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Provider Business Mailing Address
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Address Line | 1211 NOBLE ST APT 4
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City | PHILADELPHIA
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State | PA
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Zip | 19123-3672
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Country | US
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Telephone | 918-269-8517
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Fax |
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Authorized Official
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Title or Position | DR.
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Name | COURTNEY LAM
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Credential | DMD
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Telephone | 918-269-8517
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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 |
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License Number State |
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