Provider Demographics
NPI:1699268052
Name:LAI, CHRISTOPHER REX (DMD)
Entity type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:REX
Last Name:LAI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8-166 MOOS HEALTH SCIENE TOWER
Mailing Address - Street 2:515 DELAWARE ST. SE
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-624-9900
Mailing Address - Fax:
Practice Address - Street 1:8-166 MOOS HEALTH SCIENE TOWER
Practice Address - Street 2:515 DELAWARE ST. SE
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-624-9900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-11
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR7051223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics