Healthcare Provider Details

I. General information

NPI: 1518078302
Provider Name (Legal Business Name): YUHOU LIU DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3915 MAIN ST STE 208
FLUSHING NY
11354
US

IV. Provider business mailing address

3915 MAIN ST STE 208
FLUSHING NY
11354
US

V. Phone/Fax

Practice location:
  • Phone: 718-353-8950
  • Fax: 718-353-8951
Mailing address:
  • Phone: 718-353-8950
  • Fax: 718-353-8951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number049775
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: