Healthcare Provider Details
I. General information
NPI: 1932228681
Provider Name (Legal Business Name): HOWARD LIU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1111 CIVIC DR STE 145
WALNUT CREEK CA
94596-8229
US
IV. Provider business mailing address
1111 CIVIC DR STE 145
WALNUT CREEK CA
94596-8229
US
V. Phone/Fax
- Phone: 530-425-3898
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | 59043 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: