Organization
DONNA LIEU DDS INC.
Active
Other names
Beverly Grove Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA LIEU (CEO)
(323) 933-9349
Entity
Organization
Contact information
Practice address
6200 WILSHIRE BLVD STE 1109, LOS ANGELES, CA 90048-5812
(323) 933-9349
Mailing address
6200 WILSHIRE BLVD STE 1109, LOS ANGELES, CA 90048-5812
(323) 933-9349
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225288525
NPI
—
Enumeration date
08/15/2018
Last updated
08/15/2018
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