Provider Demographics
NPI:1568638971
Name:LAMWATT, JOLYON (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOLYON
Middle Name:
Last Name:LAMWATT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7600 DOCTOR PHILLIPS BOULEVARD
Mailing Address - Street 2:SUITE 62
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32819
Mailing Address - Country:US
Mailing Address - Phone:407-352-9687
Mailing Address - Fax:407-352-8683
Practice Address - Street 1:7600 DOCTOR PHILLIPS BOULEVARD
Practice Address - Street 2:SUITE 62
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32819
Practice Address - Country:US
Practice Address - Phone:407-352-9687
Practice Address - Fax:407-352-8683
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 127361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice