Individual
DR. TIDA LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
7101 HOFF ST, FORT BENNING, GA 31905-5645
(706) 544-4795
Mailing address
7101 HOFF ST, FORT BENNING, GA 31905-5645
(706) 544-4795
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2019023090
MO
Other
Enumeration date
08/02/2019
Last updated
08/02/2019
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