Provider Demographics
NPI:1588608228
Name:LAMPARD, CAROLYN SAWICKI (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:SAWICKI
Last Name:LAMPARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 VALLEY VIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOUNA
Mailing Address - State:PA
Mailing Address - Zip Code:16602
Mailing Address - Country:US
Mailing Address - Phone:814-946-5060
Mailing Address - Fax:814-946-4899
Practice Address - Street 1:901 VALLEY VIEW BLVD
Practice Address - Street 2:
Practice Address - City:ALTOUNA
Practice Address - State:PA
Practice Address - Zip Code:16602
Practice Address - Country:US
Practice Address - Phone:814-946-5060
Practice Address - Fax:814-946-4899
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS031238R122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0018753130005Medicaid
607451OtherBLUE SHIELD
PA136360Medicare PIN
607451OtherBLUE SHIELD