Provider Demographics
NPI:1780022004
Name:LAMM, BRENT ABRAHAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:ABRAHAM
Last Name:LAMM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16085 E EASTER CIR # 9-204
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5103
Mailing Address - Country:US
Mailing Address - Phone:801-721-3205
Mailing Address - Fax:
Practice Address - Street 1:12090 E ALAMEDA AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-1216
Practice Address - Country:US
Practice Address - Phone:303-360-8365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-08
Last Update Date:2013-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10647122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist