MEDICARE: DR. LOUIS MARK LAMBUSTA JR. D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DI013207	NJ

General Provider Information

NPI Number	:	1407986565
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LOUIS MARK LAMBUSTA JR. D.D.S.

Provider Business Mailing Address
First Line	:	2911 ROUTE 88 STE 2
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2871
Country	:	US
Telephone Number	:	732-295-0022
Fax Number	:	732-295-7047

Provider Business Practice Location Address
First Line	:	2911 ROUTE 88 STE 2
Second Line	:
City	:	POINT PLEASANT BORO
State	:	NJ
Zip	:	08742-2871
Country	:	US
Telephone Number	:	732-295-0022
Fax Number	:	732-295-7047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	07/08/2007

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