Individual
DR. SUSAN DIFABIO LAMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD MS
Contact information
Practice address
1531 TAMIAMI TRAIL S, SUITE 701, VENICE, FL 34285-5575
(941) 497-5591
(941) 408-9351
Mailing address
1531 TAMIAMI TRAIL S, SUITE 701, VENICE, FL 34285-5575
(941) 497-5591
(941) 408-9351
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
DN13785
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22035524
FLA DEPT OF REVENUE
FL
Enumeration date
03/09/2007
Last updated
03/07/2023
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