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Organization
JUNG JUNG LIU
Active
Organization
JUNG JUNG LIU
Active
Other names
Academy Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHANIE JUNG LIU DDS (OWNER)
(626) 966-8408
Entity
Organization
Contact information
Practice address
628 NORTH AZUSA AVE, WEST COVINA, CA 91791
(626) 966-8408
(626) 967-4557
Mailing address
628 NORTH AZUSA AVE, WEST COVINA, CA 91791
(626) 966-8408
(626) 967-4557
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
122337253
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9075801
MEDI CAL DENTI CAL
CA
Enumeration date
03/23/2007
Last updated
07/07/2008
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