Provider Demographics
NPI:1811001977
Name:LAMBERT, ROGER JOSEPH (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROGER
Middle Name:JOSEPH
Last Name:LAMBERT
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:PO BOX 850
Mailing Address - Street 2:35344 HWY 41
Mailing Address - City:COARSEGOLD
Mailing Address - State:CA
Mailing Address - Zip Code:93614
Mailing Address - Country:US
Mailing Address - Phone:559-683-8550
Mailing Address - Fax:559-658-8552
Practice Address - Street 1:35344 HWY 41
Practice Address - Street 2:
Practice Address - City:COARSEGOLD
Practice Address - State:CA
Practice Address - Zip Code:93614
Practice Address - Country:US
Practice Address - Phone:559-683-8550
Practice Address - Fax:559-658-8552
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA222421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice