Provider Demographics
NPI:1497831382
Name:KENNETH C. LAMBERT, JR. D.M.D., P.C.
Entity Type:Organization
Organization Name:KENNETH C. LAMBERT, JR. D.M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:CHARLES
Authorized Official - Last Name:LAMBERT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:251-343-1007
Mailing Address - Street 1:6320 PICCADILLY SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609-5143
Mailing Address - Country:US
Mailing Address - Phone:251-343-1007
Mailing Address - Fax:251-343-1079
Practice Address - Street 1:6320 PICCADILLY SQUARE DR
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5143
Practice Address - Country:US
Practice Address - Phone:251-343-1007
Practice Address - Fax:251-343-1079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL41731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty