Provider Demographics
NPI:1700133279
Name:JAMES W LAMB III DMD MS PC
Entity Type:Organization
Organization Name:JAMES W LAMB III DMD MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:W
Authorized Official - Last Name:LAMB
Authorized Official - Suffix:III
Authorized Official - Credentials:DMD
Authorized Official - Phone:678-455-7828
Mailing Address - Street 1:285 ELM ST STE 103
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-8233
Mailing Address - Country:US
Mailing Address - Phone:678-455-7828
Mailing Address - Fax:678-455-7831
Practice Address - Street 1:285 ELM ST STE 103
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8233
Practice Address - Country:US
Practice Address - Phone:678-455-7828
Practice Address - Fax:678-455-7831
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA012268261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA012268OtherGEORGIA DENTAL LISCENSE