Individual
JIA LIU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1372 HANCOCK ST STE 101, QUINCY, MA 02169-5107
(617) 472-3919
Mailing address
629 HAMMOND ST UNIT E201, CHESTNUT HILL, MA 02467-2172
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN1858577
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2017
Last updated
11/15/2022
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