Provider Demographics
NPI:1942844998
Name:COURTNEY J LAM DMD PLLC
Entity Type:Organization
Organization Name:COURTNEY J LAM DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:COURTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:918-269-8517
Mailing Address - Street 1:1211 NOBLE ST APT 4
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-3672
Mailing Address - Country:US
Mailing Address - Phone:918-269-8517
Mailing Address - Fax:
Practice Address - Street 1:244 ADELIA ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:PA
Practice Address - Zip Code:17057-2711
Practice Address - Country:US
Practice Address - Phone:918-269-8517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-03
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental