MEDICARE: ANDREW THOMAS LAI 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	DE0009768	WA

General Provider Information

NPI Number	:	1952597775
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW THOMAS LAI DDS

Provider Business Mailing Address
First Line	:	231 SE BARRINGTON DR
Second Line	:	SUITE 202
City	:	OAK HARBOR
State	:	WA
Zip	:	98277-3200
Country	:	US
Telephone Number	:	360-682-5488
Fax Number	:	360-720-2926

Provider Business Practice Location Address
First Line	:	2105 CONTINENTAL PL STE A
Second Line	:
City	:	MOUNT VERNON
State	:	WA
Zip	:	98273-4104
Country	:	US
Telephone Number	:	360-848-7473
Fax Number	:	360-848-6585

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

Provider Enumeration Date	:	09/16/2007
Last Update Date	:	02/03/2012

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