Provider Demographics
NPI:1194239756
Name:MAUREEN LAM DDS, P.C.
Entity type:Organization
Organization Name:MAUREEN LAM DDS, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MAUREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-888-8288
Mailing Address - Street 1:13347 SANFORD AVE STE C1B
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-5870
Mailing Address - Country:US
Mailing Address - Phone:718-888-8828
Mailing Address - Fax:
Practice Address - Street 1:13347 SANFORD AVE STE C1B
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-5870
Practice Address - Country:US
Practice Address - Phone:718-888-8828
Practice Address - Fax:718-888-8828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-18
Last Update Date:2017-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY393251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty