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General NPI Number Information
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NPI Number | 1518081587
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Entity Type | Organization
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Legal Business Name | JOSHUA S. LIAO, D.D.S. INC
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1140 S SAN GABRIEL BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3115
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Country | US
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Telephone | 626-614-0909
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Fax | 626-614-0191
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Provider Business Mailing Address
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Address Line | 1140 S SAN GABRIEL BLVD
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City | SAN GABRIEL
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State | CA
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Zip | 91776-3115
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Country | US
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Telephone | 626-614-0909
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Fax | 626-614-0191
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOSHUA S. LIAO
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Credential | D.D.S.
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Telephone | 626-614-0909
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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 | 34987
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License Number State | CA
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