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General NPI Number Information
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NPI Number | 1518409770
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER LAI DDS APDC
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Dates
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Enumeration Date | 11/04/2016
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Last Update Date | 11/04/2016
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Provider Practice Location Address
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Address Line | 2320 S ROBERTSON BLVD 102
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City | LOS ANGELES
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State | CA
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Zip | 90034-2060
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Country | US
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Telephone | 310-839-8831
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Fax | 310-839-6938
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Provider Business Mailing Address
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Address Line | 2320 S ROBERTSON BLVD 102
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City | LOS ANGELES
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State | CA
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Zip | 90034-2060
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Country | US
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Telephone | 310-839-8831
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Fax | 310-839-6938
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER THIEU LAI
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Credential | MS DDS
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Telephone | 310-839-8831
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 57649
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License Number State | CA
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