Provider Demographics
NPI:1275751190
Name:LAI, EN LIENG (DMD)
Entity Type:Individual
Prefix:DR
First Name:EN LIENG
Middle Name:
Last Name:LAI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:E
Other - Last Name:LAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:6605 W BOYNTON BEACH BLVD
Mailing Address - Street 2:FOUNTAINS OF BOYNTON DENTAL CTR
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33437-3526
Mailing Address - Country:US
Mailing Address - Phone:561-364-8088
Mailing Address - Fax:561-742-2808
Practice Address - Street 1:6605 W BOYNTON BEACH BLVD
Practice Address - Street 2:FOUNTAINS OF BOYNTON DENTAL CTR
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33437-3526
Practice Address - Country:US
Practice Address - Phone:561-364-8088
Practice Address - Fax:561-742-2808
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN13549122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist