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NPI Code Detail

MEDICARE: DR. DAVID MICHAEL LIEUX D.D.S.

MEDICARE: DR. DAVID MICHAEL LIEUX D.D.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
11223G0001XGeneral Practice Dentistry5296AL

General Provider Information

NPI Number : 1831208750
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID MICHAEL LIEUX D.D.S.
Provider Business Mailing Address
First Line : 3150 ZELDA CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2607
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3150 ZELDA CT
Second Line :
City : MONTGOMERY
State : AL
Zip : 36106-2607
Country : US
Telephone Number : 334-281-2451
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2006
Last Update Date : 07/08/2007

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