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General NPI Number Information
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NPI Number | 1003440512
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Entity Type | Individual
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Provider Name | LIEN PEREZ GARCIA DMD
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Gender | Female
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Dates
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Enumeration Date | 02/24/2020
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Last Update Date | 05/19/2022
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Provider Practice Location Address
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Address Line | 2000 NW 87TH AVE STE 215
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City | DORAL
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State | FL
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Zip | 33172-2657
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Country | US
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Telephone | 786-953-6550
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Fax |
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Provider Business Mailing Address
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Address Line | 676 SE 8TH ST
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City | HIALEAH
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State | FL
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Zip | 33010-5607
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Country | US
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Telephone | 305-490-1023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | DN26829
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN26829
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | DRPM2123
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN26829
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License Number State | FL
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