Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 9936 | CO |
N | 213EG0000X | General Practice | 9936 | CO |
Y | 1223P0300X | Periodontist | D9936 | CO |
N | 204E00000X | Oral & Maxillofacial Surgeon | D12915 | MN |
NPI | 1184851925 |
---|---|
Provider Name | Pearl Lai |
First Address | Westminster, CO 80031-7041 |
Second Address | Westminster, CO 80031-7041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/06/2009 |
Last Update Date | 17/09/2014 |