Provider Demographics
NPI:1407940844
Name:LAMBERT, KURT P (DDS)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:P
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 1:4101 MORRIS ST NE STE D
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-3605
Mailing Address - Country:US
Mailing Address - Phone:505-294-2974
Mailing Address - Fax:505-291-8415
Practice Address - Street 1:5909 ALICE NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110
Practice Address - Country:US
Practice Address - Phone:505-268-6388
Practice Address - Fax:505-254-2461
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD1632122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist