Individual
DR. MARK ADAM LIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
7911 41ST AVE, SUITE A-107, ELMHURST, NY 11373-1258
(718) 205-2888
Mailing address
101 W 80TH ST APT 2F, NEW YORK, NY 10024-7103
(646) 934-0000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
051846
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02654479
—
NY
Enumeration date
12/04/2006
Last updated
06/10/2013
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