Provider Demographics
NPI:1790205441
Name:LAMB DENTAL SERVICES
Entity Type:Organization
Organization Name:LAMB DENTAL SERVICES
Other - Org Name:SIENNA DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:954-283-7085
Mailing Address - Street 1:4747 SW 39TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33312-5450
Mailing Address - Country:US
Mailing Address - Phone:954-907-0271
Mailing Address - Fax:954-252-2306
Practice Address - Street 1:2700 S UNIVERSITY DR
Practice Address - Street 2:
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33025-3015
Practice Address - Country:US
Practice Address - Phone:954-283-7085
Practice Address - Fax:954-252-2306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-23
Last Update Date:2017-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20725261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental