Individual
JULIA LAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3749 82ND ST FL 2, JACKSON HEIGHTS, NY 11372-7031
(321) 514-2563
Mailing address
1356 1ST AVE APT 3G, NEW YORK, NY 10021-4487
(321) 514-2563
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
064040
NY
1223G0001X
General Practice Dentistry
064040
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2023
Last updated
08/18/2024
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