MEDICARE: JULAI DENTAL, PLLC

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	29013	TX

General Provider Information

NPI Number	:	1134510571
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JULAI DENTAL, PLLC

Provider Business Mailing Address
First Line	:	2828 HAYES RD
Second Line	:	APT 513
City	:	HOUSTON
State	:	TX
Zip	:	77082-6633
Country	:	US
Telephone Number	:	281-940-5524
Fax Number	:

Provider Business Practice Location Address
First Line	:	15455 MEMORIAL DR
Second Line	:	STE 400
City	:	HOUSTON
State	:	TX
Zip	:	77079-4135
Country	:	US
Telephone Number	:	281-940-5524
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	DR. JUSTIN T LAI
Credential	:	DDS
Telephone Number	:	281-940-5524

Provider Enumeration Date	:	02/06/2015
Last Update Date	:	02/06/2015

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