Healthcare Provider Details

I. General information

NPI: 1497975932
Provider Name (Legal Business Name): KAREN LIU DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5133 S CAMPBELL AVE SUITE 202
SPRINGFIELD MO
65810-2406
US

IV. Provider business mailing address

5133 S CAMPBELL AVE SUITE 202
SPRINGFIELD MO
65810-2406
US

V. Phone/Fax

Practice location:
  • Phone: 417-886-1010
  • Fax: 417-886-1216
Mailing address:
  • Phone: 417-886-1010
  • Fax: 417-886-1216

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2001007168
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: