Organization
OLIVE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. QIONG ZHOU LIU DDS (OWNER)
(405) 470-2200
Entity
Organization
Contact information
Practice address
5500 NW EXPRESSWAY STE B, WARR ACRES, OK 73132-5218
(405) 470-2200
(405) 470-2392
Mailing address
5500 NW EXPRESSWAY STE B, WARR ACRES, OK 73132-5218
(405) 470-2200
(405) 470-2392
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
OK6497
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1629400510
—
OK
Enumeration date
12/19/2017
Last updated
06/11/2019
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