Provider Demographics
NPI:1700288792
Name:LAMBARIA, RAMIRO III (DMD)
Entity Type:Individual
Prefix:
First Name:RAMIRO
Middle Name:
Last Name:LAMBARIA
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5303 E CORTLAND BLVD APT K08
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86004-9580
Mailing Address - Country:US
Mailing Address - Phone:810-347-7117
Mailing Address - Fax:
Practice Address - Street 1:455 CHERRY ST SE STE 1
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-4658
Practice Address - Country:US
Practice Address - Phone:616-458-8593
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-22
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901021412122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist