Individual
WAI BUN LIEW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2508 BERT KOUNS INDUSTRIAL LOOP STE 403, SHREVEPORT, LA 71118-3157
(857) 347-1390
Mailing address
2508 BERT KOUNS INDUSTRIAL LOOP STE 403, SHREVEPORT, LA 71118-3157
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
S-1219
LA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/31/2020
Last updated
06/12/2026
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