Individual
KENNY LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1898 CEDAR ST APT A, ALHAMBRA, CA 91801-1810
(661) 496-9355
Mailing address
1898 CEDAR ST APT A, ALHAMBRA, CA 91801-1810
(661) 496-9355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
53822
CA
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
53822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D53822
DENTI-CAL PROVIDER NUMBER
CA
Enumeration date
03/12/2007
Last updated
02/25/2014
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