Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | 2901021344 | MI |
Y | 1223P0300X | Periodontist | 2901021344 | MI |
NPI | 1134535412 |
---|---|
Provider Name | Dr. Monica Ann Lamble |
First Address | Saginaw, MI 48638-7101 |
Second Address | Saginaw, MI 48638-7101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2014 |
Last Update Date | 17/03/2018 |