Individual
SUSAN LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
30040 SW BOONES FERRY RD STE 20, WILSONVILLE, OR 97070-8910
(503) 682-4500
Mailing address
12676 SW 133RD AVE, TIGARD, OR 97223-4714
(503) 927-8086
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D11824
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2023
Last updated
06/28/2023
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