Provider Demographics
NPI:1235332297
Name:GILBERT LAY DDS
Entity Type:Organization
Organization Name:GILBERT LAY DDS
Other - Org Name:NORWALK FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GILBERT
Authorized Official - Middle Name:KHIN
Authorized Official - Last Name:LAY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-505-7002
Mailing Address - Street 1:12319 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CA
Mailing Address - Zip Code:90650-8303
Mailing Address - Country:US
Mailing Address - Phone:562-868-7955
Mailing Address - Fax:562-929-8052
Practice Address - Street 1:13922 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638
Practice Address - Country:US
Practice Address - Phone:502-926-7025
Practice Address - Fax:502-926-0956
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GILBERT LAY DDS / LA MIRADA FAMILY DENTAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-06-07
Last Update Date:2015-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40648122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty