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NPI Code Detail

MEDICARE: DR. RICHARD J LAM DMD

MEDICARE: DR. RICHARD J LAM DMD
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
11223G0001XGeneral Practice Dentistry04488NH
21223G0001XGeneral Practice DentistryDN1858293MA

General Provider Information

NPI Number : 1720645047
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD J LAM DMD
Provider Business Mailing Address
First Line : 10 LEYDEN ST UNIT 2
Second Line :
City : MEDFORD
State : MA
Zip : 02155-6633
Country : US
Telephone Number : 617-792-3674
Fax Number :
Provider Business Practice Location Address
First Line : 19 BARNARD ST
Second Line :
City : ANDOVER
State : MA
Zip : 01810-3601
Country : US
Telephone Number : 978-475-5333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2019
Last Update Date : 06/17/2019

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