MEDICARE: DR. CATHERINE JYNGWAN LAU DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	60520	CA

General Provider Information

NPI Number	:	1194169904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CATHERINE JYNGWAN LAU DDS

Provider Business Mailing Address
First Line	:	7982 AMADOR VALLEY BLVD
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-2308
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7982 AMADOR VALLEY BLVD
Second Line	:
City	:	DUBLIN
State	:	CA
Zip	:	94568-2308
Country	:	US
Telephone Number	:	510-364-4857
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2013
Last Update Date	:	07/23/2013

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