Individual
DR. AMITABHA LALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
517 ROGERS ST, LOWELL, MA 01852
(978) 454-0977
(978) 458-8776
Mailing address
517 ROGERS ST, LOWELL, MA 01852
(978) 454-0977
(978) 458-8776
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
20359
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9713247
—
MA
01
—
X11622
BLUE CROSS BLUE SHIELD
MA
Enumeration date
08/24/2006
Last updated
07/08/2007
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