Basic Information
| Provider Information | |||||||||
| NPI: | 1740342682 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LAMBOURNE | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | CHAD | ||||||||
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| Credential: | DDS, MS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 152 S 32ND ST W | ||||||||
| Address2: | SUITE A | ||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591026875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062454414 | ||||||||
| FaxNumber: | 4062944416 | ||||||||
| Practice Location | |||||||||
| Address1: | 152 S 32ND ST W | ||||||||
| Address2: | SUITE A | ||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591026875 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062454414 | ||||||||
| FaxNumber: | 4062944416 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/15/2006 | ||||||||
| LastUpdateDate: | 03/16/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223X0400X | 6377376-9921 | UT | N | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics | 1223X0400X | 050699 | NY | N | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics | 1223X0400X | D-3940-OR | ID | N | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics | 1223X0400X | 2356 | MT | Y | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics | 1223X0400X | 1395 | WY | N | Dental Providers | Dentist | Orthodontics and Dentofacial Orthopedics |
No ID Information.