Individual
JACK LAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
53 ELIZABETH ST # 2F, NEW YORK, NY 10013-4617
(212) 219-8182
Mailing address
53 ELIZABETH ST FL 2, NEW YORK, NY 10013-4617
(212) 219-8182
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
060534
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060534
LICENSE
NY
Enumeration date
01/11/2019
Last updated
08/11/2024
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