Provider Demographics
NPI:1578963559
Name:KARL G. LUM JR., D.D.S. AND ROBERT M. LUM, D.D.S., INC
Entity Type:Organization
Organization Name:KARL G. LUM JR., D.D.S. AND ROBERT M. LUM, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:GUT
Authorized Official - Last Name:LUM
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-792-3286
Mailing Address - Street 1:39572 STEVENSON PL STE 223
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3112
Mailing Address - Country:US
Mailing Address - Phone:510-792-3286
Mailing Address - Fax:510-792-3298
Practice Address - Street 1:39572 STEVENSON PL STE 223
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3112
Practice Address - Country:US
Practice Address - Phone:510-792-3286
Practice Address - Fax:510-792-3298
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-27
Last Update Date:2014-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39984122300000X
CA43812122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty