Provider Demographics
NPI:1538481528
Name:DENNIS LAI
Entity Type:Organization
Organization Name:DENNIS LAI
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:LAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:916-422-2102
Mailing Address - Street 1:7210 S LAND PARK DR STE F
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3663
Mailing Address - Country:US
Mailing Address - Phone:916-422-2102
Mailing Address - Fax:
Practice Address - Street 1:7210 S LAND PARK DR STE F
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3663
Practice Address - Country:US
Practice Address - Phone:916-422-2102
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DENNIS LAI
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA258151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty