| Jim Lam Dds Pllc | |
|
6821 Doniphan Dr Canutillo TX 79835-5402 | |
| (915) 877-4949 | |
| (915) 877-4242 |
| Full Name | Jim Lam Dds Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 6821 Doniphan Dr, Canutillo, Texas |
| Authorized Official Name and Position | Jim Lam (DENTIST) |
| Authorized Official Contact | 6262356572 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jim Lam Dds Pllc 6821 Doniphan Dr Canutillo TX 79835-5402 Ph: (915) 877-4949 | Jim Lam Dds Pllc 6821 Doniphan Dr Canutillo TX 79835-5402 Ph: (915) 877-4949 |
| NPI Number | 1083386114 |
|---|---|
| Provider Enumeration Date | 09/28/2021 |
| Last Update Date | 03/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083386114 | NPI | - | NPPES |
| 36284785 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
Doniphan Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 6821 Doniphan Dr, Canutillo, TX 79835 Phone: 915-788-4949 Fax: 915-877-4242 |