Provider Demographics
NPI:1497099345
Name:LAU, VI HANG (DDS)
Entity Type:Individual
Prefix:DR
First Name:VI
Middle Name:HANG
Last Name:LAU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 PALM AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-6529
Mailing Address - Country:US
Mailing Address - Phone:619-469-4342
Mailing Address - Fax:619-469-7022
Practice Address - Street 1:4333 PALM AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-6529
Practice Address - Country:US
Practice Address - Phone:619-469-4342
Practice Address - Fax:619-469-7022
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53037122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist