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NPI Code Detail

MEDICARE: DR. KENNETH K LIAO D.D.S.,M.S.

MEDICARE:  DR. KENNETH K LIAO  D.D.S.,M.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223E0200XEndodontics38965NY

General Provider Information

NPI Number : 1033211073
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KENNETH K LIAO D.D.S.,M.S.
Provider Business Mailing Address
First Line : 1229 BROADWAY
Second Line :
City : HEWLETT
State : NY
Zip : 11557-2014
Country : US
Telephone Number : 516-374-0685
Fax Number : 516-374-0694
Provider Business Practice Location Address
First Line : 1229 BROADWAY
Second Line :
City : HEWLETT
State : NY
Zip : 11557-2014
Country : US
Telephone Number : 516-374-0685
Fax Number : 516-374-0694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/01/2006
Last Update Date : 07/08/2007

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Directions to “ DR. KENNETH K LIAO D.D.S.,M.S.” Practice Location

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