Organization
DR. NATHANIEL S. LIU, DDS A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NATHANIEL S LIU DDS (DENTIST OWNER)
(619) 259-4001
Entity
Organization
Contact information
Practice address
28350 VIA SANTA ROSA, TEMECULA, CA 92590-5335
(619) 259-4001
(619) 393-0413
Mailing address
28350 VIA SANTA ROSA, TEMECULA, CA 92590-5335
(619) 259-4001
(619) 393-0413
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
99424
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
924775
UNITED CONCORDIA
CA
05
—
G9242601
—
CA
01
—
G9818801
DELTA DENTAL
CA
Enumeration date
06/26/2007
Last updated
07/21/2022
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