Provider Demographics
NPI:1588858831
Name:KARL G LUM JR DDS AND ROBERT M LUM DDS
Entity Type:Organization
Organization Name:KARL G LUM JR DDS AND ROBERT M LUM DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KARL
Authorized Official - Middle Name:G
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
Mailing Address - Street 2:#223
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3075
Mailing Address - Country:US
Mailing Address - Phone:510-792-3286
Mailing Address - Fax:510-792-3298
Practice Address - Street 1:39572 STEVENSON PL
Practice Address - Street 2:#223
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3075
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:2007-08-30
Last Update Date:2007-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA399841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty