Provider Demographics
NPI:1811028350
Name:MINIUM, KEARNS AND LAMB ORTHODONTISTS
Entity Type:Organization
Organization Name:MINIUM, KEARNS AND LAMB ORTHODONTISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:A
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-774-1200
Mailing Address - Street 1:1412 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:NEW CUMBERLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17070-1117
Mailing Address - Country:US
Mailing Address - Phone:717-774-1200
Mailing Address - Fax:717-774-2568
Practice Address - Street 1:1412 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:NEW CUMBERLAND
Practice Address - State:PA
Practice Address - Zip Code:17070-1117
Practice Address - Country:US
Practice Address - Phone:717-774-1200
Practice Address - Fax:717-774-2568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-08
Last Update Date:2016-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS020106L DS028294L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMI279056OtherUNITED CONCORDIA PROV. #