Provider Demographics
NPI:1811054729
Name:KAMEL, LANCE JONATHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:JONATHAN
Last Name:KAMEL
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 1:8269 W SUNRISE BLVD
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33322-5403
Mailing Address - Country:US
Mailing Address - Phone:954-472-2000
Mailing Address - Fax:954-472-1381
Practice Address - Street 1:8269 W SUNRISE BLVD
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33322-5403
Practice Address - Country:US
Practice Address - Phone:954-472-2000
Practice Address - Fax:954-472-1381
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2010-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN157711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice