Individual
SU HSIN LIAO TUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
503 CEDAR ST, TIPTON, IA 52772-1738
(563) 886-3233
Mailing address
PO BOX 463, 503 CEDAR ST, TIPTON, IA 52772
(563) 886-3223
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6194
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0140582
—
IA
Enumeration date
11/30/2006
Last updated
07/08/2007
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