Organization
LAM-GEISE DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE LAM GEISE DMD (PRESIDENT)
(334) 220-9646
Entity
Organization
Contact information
Practice address
577 HUGHES RD, MADISON, AL 35758
(256) 461-8607
Mailing address
577 HUGHES RD, MADISON, AL 35758-8979
(256) 461-8607
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
5853
AL
122300000X
Dentist
Primary
6107
AL
1223G0001X
General Practice Dentistry
4002
AL
Other
Enumeration date
12/12/2016
Last updated
12/14/2016
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