Provider Demographics
NPI:1407986565
Name:LAMBUSTA, LOUIS MARK JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:MARK
Last Name:LAMBUSTA
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2911 ROUTE 88 STE 2
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT BORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08742-2871
Mailing Address - Country:US
Mailing Address - Phone:732-295-0022
Mailing Address - Fax:732-295-7047
Practice Address - Street 1:2911 ROUTE 88 STE 2
Practice Address - Street 2:
Practice Address - City:POINT PLEASANT BORO
Practice Address - State:NJ
Practice Address - Zip Code:08742-2871
Practice Address - Country:US
Practice Address - Phone:732-295-0022
Practice Address - Fax:732-295-7047
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI013207122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist