Provider Demographics
NPI:1558382812
Name:LAM, ALBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALBERT
Middle Name:
Last Name:LAM
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15803 HESPERIAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:CA
Mailing Address - Zip Code:94580-1537
Mailing Address - Country:US
Mailing Address - Phone:510-276-1900
Mailing Address - Fax:510-276-7894
Practice Address - Street 1:15803 HESPERIAN BLVD
Practice Address - Street 2:
Practice Address - City:SAN LORENZO
Practice Address - State:CA
Practice Address - Zip Code:94580-1537
Practice Address - Country:US
Practice Address - Phone:510-276-1900
Practice Address - Fax:510-276-7894
Is Sole Proprietor?:No
Enumeration Date:2006-07-22
Last Update Date:2010-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI028971223X0400X
MA209501223X0400X
CA571041223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics