Provider Demographics
NPI:1962697110
Name:N. KENNETH LAMURA, DDS, PC
Entity type:Organization
Organization Name:N. KENNETH LAMURA, DDS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RECEPTIONIST
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:J
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:CDA
Authorized Official - Phone:508-347-9503
Mailing Address - Street 1:58 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:STURBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01566-1507
Mailing Address - Country:US
Mailing Address - Phone:508-347-9503
Mailing Address - Fax:508-347-5337
Practice Address - Street 1:58 MAIN ST
Practice Address - Street 2:
Practice Address - City:STURBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:01566-1507
Practice Address - Country:US
Practice Address - Phone:508-347-9503
Practice Address - Fax:508-347-5337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA117561223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA16340OtherHARVARD PILGRIM
MA98379601OtherNETWORK HEALTH
MA0011756BOtherFALLON
MA0100197OtherDELTA DENTAL OF MA
MAX10159 / V04120OtherBCBS OF MA
MA43942OtherCIGNA
MA011756BOtherTUFTS
MA16340OtherHARVARD PILGRIM
MA011756BOtherTUFTS