MEDICARE: HURD LAU DENTAL PARTNERS

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry
2	1223D0004X	Dental Anesthesiology
3	261QA1903X	Ambulatory Surgical Clinic/Center
4	1223P0221X	Pediatric Dentistry

General Provider Information

NPI Number	:	1790666170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HURD LAU DENTAL PARTNERS

Provider Business Mailing Address
First Line	:	PO BOX 190565
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94119-0565
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2177 3RD ST UNIT C3
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94107-3985
Country	:	US
Telephone Number	:	415-376-5002
Fax Number	:

Authorized Official
Title or Position	:	PARTNER
Name	:	JERRY LAU
Credential	:	DDS
Telephone Number	:	415-376-5002

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	09/16/2025

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