Provider Demographics
NPI:1407137995
Name:LAU, DOMINIC SZE YAN (DDS)
Entity Type:Individual
Prefix:MR
First Name:DOMINIC
Middle Name:SZE YAN
Last Name:LAU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11040-5540
Mailing Address - Country:US
Mailing Address - Phone:516-424-6946
Mailing Address - Fax:
Practice Address - Street 1:1405 5TH AVE
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-5540
Practice Address - Country:US
Practice Address - Phone:516-424-6946
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program