Provider Demographics
NPI:1053558858
Name:SHEILA M. LAM, DDS
Entity type:Organization
Organization Name:SHEILA M. LAM, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:M
Authorized Official - Last Name:LAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-227-7055
Mailing Address - Street 1:485 WILDWOOD PKWY
Mailing Address - Street 2:STE #3
Mailing Address - City:BALLWIN
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2667
Mailing Address - Country:US
Mailing Address - Phone:636-227-7055
Mailing Address - Fax:636-527-3900
Practice Address - Street 1:485 WILDWOOD PKWY
Practice Address - Street 2:STE #3
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2667
Practice Address - Country:US
Practice Address - Phone:636-227-7055
Practice Address - Fax:636-527-3900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty