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General NPI Number Information
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NPI Number | 1366566481
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Entity Type | Organization
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Legal Business Name | LILIANI I. LIEM, DDS, INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 09/09/2008
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Provider Practice Location Address
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Address Line | 27131 ALISO CREEK RD SUITE 120
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3363
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Country | US
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Telephone | 949-362-3668
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Fax | 949-362-4683
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Provider Business Mailing Address
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Address Line | 27131 ALISO CREEK RD SUITE 120
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City | ALISO VIEJO
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State | CA
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Zip | 92656-3363
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Country | US
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Telephone | 949-362-3668
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Fax | 949-362-4683
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Authorized Official
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Title or Position | DENTIST - OWNER
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Name | DR. LILIANI INGE LIEM
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Credential | D.D.S.
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Telephone | 949-362-3668
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 34850
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License Number State | CA
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