Individual
KIET H LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
2472 W FOSTER AVE, STE 101, CHICAGO, IL 60625-6962
(773) 334-9922
(773) 334-9928
Mailing address
2472 W FOSTER AVE, STE 101, CHICAGO, IL 60625-6962
(773) 334-9922
(773) 334-9928
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025168
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005225
—
IL
Enumeration date
11/05/2008
Last updated
11/05/2008
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