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Organization
PEIXIN LIU DDS
Active
Organization
PEIXIN LIU DDS
Active
Other names
Family Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERI L MURRAY ROA (OFFICE MANAGER)
(763) 783-8200
Entity
Organization
Contact information
Practice address
2407 109TH AVENUE, SUITE 240, BLAINE, MN 55449
(763) 783-8200
(763) 783-7197
Mailing address
2407 109TH AVENUE, SUITE 240, BLAINE, MN 55449
(763) 783-8200
(763) 783-7197
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D11232MN
MN
1223G0001X
General Practice Dentistry
D12319MN
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1760540942
NPI
—
01
—
1972584068
NPI
—
01
—
D11232
MN LICENSE
MN
01
—
D12319
MN LICENSE
MN
Enumeration date
04/02/2008
Last updated
04/02/2008
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