Individual
QIYU LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 ESSEX ST UNIT 1A1, LAWRENCE, MA 01841-4396
(978) 683-2200
Mailing address
9 DEMAR RD, LEXINGTON, MA 02420-1301
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DN1859203
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/16/2021
Last updated
10/15/2021
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