Provider Demographics
NPI:1487776522
Name:LAMBERT, PHILLIP D (DDS)
Entity type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:D
Last Name:LAMBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2385 WARRIOR LN
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89523-9544
Mailing Address - Country:US
Mailing Address - Phone:775-345-0118
Mailing Address - Fax:775-345-1625
Practice Address - Street 1:532 HUMBOLDT ST
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1602
Practice Address - Country:US
Practice Address - Phone:775-786-6168
Practice Address - Fax:775-786-6894
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV677122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist