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Provider Information for 1386773166

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DR. BRENT CARL LAY DDS

Gender: MALE

Individual NPI: 1386773166

Calendar   Last Updated:  2007-07-08
  Certification Date: 

Details

Name Value
NPI 1386773166
Enumeration Date 2007-03-05
NPI Type 1 - Individual
Sole Proprietor YES
Status Active
Mailing Address 24900 HIGHLAND WAY
LOS GATOS, CA 95033-8002
United States

Phone: 408-353-1191 | Fax: 408-353-6501
View Map External Link
Primary Practice Address 24900 HIGHLAND WAY
LOS GATOS, CA 95033-8002
United States

Phone: 408-353-1191 | Fax: 408-353-6501
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 1223G0001X - Dentist General Practice CA 34142