Susan Lai, DMD
Dentist in Wilsonville, OR. Individual provider (NPI-1).
NPI number1104518968
StatusActive
Last updated in NPPESJun 28, 2023
Details
- NPI
- 1104518968
- Entity type
- Individual (NPI-1)
- Name
- Susan Lai
- Credential
- DMD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 22, 2023
- Certification date
- Jun 28, 2023
- Last updated
- Jun 28, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D11824 | OR | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
30040 Sw Boones Ferry Rd Ste 20Wilsonville, OR 97070-8910
Phone 503-682-4500
Mailing address
12676 Sw 133rd AveTigard, OR 97223-4714
Phone 503-927-8086
Other practice locations
2730 S Moody Ave
Portland, OR 97201-5042
Portland, OR 97201-5042
Phone 503-494-8867
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