Healthcare Provider Details

I. General information

NPI: 1023353836
Provider Name (Legal Business Name): L.M. LIU & ASSOCIATES. D.D.S., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2012
Last Update Date: 12/05/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7283 HWY 42 WEST SUITE 101
RALEIGH NC
27603
US

IV. Provider business mailing address

7283 HWY 42 WEST SUITE 101
RALEIGH NC
27603
US

V. Phone/Fax

Practice location:
  • Phone: 919-424-7203
  • Fax: 919-747-9593
Mailing address:
  • Phone: 919-424-7203
  • Fax: 919-747-9593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number8500
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8282
License Number StateNC

VIII. Authorized Official

Name: DR. LI-MING LIU
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 919-208-5896