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Organization
YIWEN LIU, DDS, A PROFESSIONAL CORPORATION
Active
Organization
YIWEN LIU, DDS, A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YIWEN LIU D.D.S. (PRESIDENT)
(310) 559-9191
Entity
Organization
Contact information
Practice address
11103 VENICE BLVD, LOS ANGELES, CA 90034-6914
(310) 559-9191
(310) 559-9797
Mailing address
2121 BELOIT AVE APT 304, LOS ANGELES, CA 90025-6263
(310) 486-9989
(310) 478-3535
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
46875
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
46875
STATE LICENSE NUMBER
CA
01
—
G93826-01
DENTI-CAL
CA
Enumeration date
10/05/2007
Last updated
10/05/2007
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