Provider Demographics
NPI:1679509210
Name:LAM, NATALIE (DMD, MMSC)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:DMD, MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA FE
Mailing Address - State:CA
Mailing Address - Zip Code:92067-0305
Mailing Address - Country:US
Mailing Address - Phone:858-756-5900
Mailing Address - Fax:858-381-5220
Practice Address - Street 1:5951 LA SENDITA
Practice Address - Street 2:SUITE B1
Practice Address - City:RANCHO SANTA FE
Practice Address - State:CA
Practice Address - Zip Code:92067
Practice Address - Country:US
Practice Address - Phone:858-756-5900
Practice Address - Fax:858-381-5220
Is Sole Proprietor?:No
Enumeration Date:2006-06-24
Last Update Date:2012-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014111491223X0400X
CA593001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics