Provider Demographics
NPI:1194926873
Name:EDWIN L. LAMB, D.M.D.,P.C.
Entity type:Organization
Organization Name:EDWIN L. LAMB, D.M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:229-247-2300
Mailing Address - Street 1:3227 N OAK STREET EXT
Mailing Address - Street 2:SUITE B
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31605-7416
Mailing Address - Country:US
Mailing Address - Phone:229-247-2300
Mailing Address - Fax:229-247-2324
Practice Address - Street 1:3227 N OAK STREET EXT
Practice Address - Street 2:SUITE B
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31605-7416
Practice Address - Country:US
Practice Address - Phone:229-247-2300
Practice Address - Fax:229-247-2324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA010407261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental