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General NPI Number Information
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NPI Number | 1659893121
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Entity Type | Organization
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Legal Business Name | CHRISTINE W. LIU, DDS, INC.
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 07/17/2017
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Provider Practice Location Address
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Address Line | 52 SKYTOP ST STE 40
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City | SAN JOSE
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State | CA
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Zip | 95134-2187
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Country | US
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Telephone | 408-755-9800
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Fax |
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Provider Business Mailing Address
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Address Line | 1066 N JACKSON AVE
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City | SAN JOSE
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State | CA
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Zip | 95133-2082
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Country | US
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Telephone | 408-391-4738
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | DR. CHRISTINE LIU
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Credential | DDS
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Telephone | 408-391-4738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State | CA
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