MEDICARE: LIANG DENTAL GROUP INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1194356840
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIANG DENTAL GROUP INC

Provider Business Mailing Address
First Line	:	5562 PHILADELPHIA ST STE 211
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2499
Country	:	US
Telephone Number	:	909-945-3656
Fax Number	:	909-464-1653

Provider Business Practice Location Address
First Line	:	5562 PHILADELPHIA ST STE 211
Second Line	:
City	:	CHINO
State	:	CA
Zip	:	91710-2499
Country	:	US
Telephone Number	:	909-945-3656
Fax Number	:	909-464-1653

Authorized Official
Title or Position	:	CEO/ENDODONTIST
Name	:	DR. HOWARD LIANG
Credential	:	DDS
Telephone Number	:	909-945-3656

Provider Enumeration Date	:	01/31/2020
Last Update Date	:	01/31/2020

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