Provider Demographics
NPI:1154525855
Name:LAU, JAMES S (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:S
Last Name:LAU
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:66450 PIERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-3672
Mailing Address - Country:US
Mailing Address - Phone:760-329-2191
Mailing Address - Fax:760-329-3581
Practice Address - Street 1:66450 PIERSON BLVD
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-3672
Practice Address - Country:US
Practice Address - Phone:760-329-2191
Practice Address - Fax:760-329-3581
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26669122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist