Individual
JESSICA R LIU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1501 N ARIZONA BLVD, COOLIDGE, AZ 85128-3215
(520) 723-1700
Mailing address
1501 N ARIZONA BLVD, COOLIDGE, AZ 85128-3215
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D011827
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
OR
Other
Enumeration date
07/07/2022
Last updated
04/19/2024
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