Provider Demographics
NPI:1467535864
Name:LIU, RICHARD YEN-TSAI (DMD)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:YEN-TSAI
Last Name:LIU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 SHATTUCK WAY #5
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03801
Mailing Address - Country:US
Mailing Address - Phone:603-436-9200
Mailing Address - Fax:603-436-9219
Practice Address - Street 1:101 SHATTUCK WAY STE 5
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:NH
Practice Address - Zip Code:03801-7876
Practice Address - Country:US
Practice Address - Phone:603-436-9200
Practice Address - Fax:603-436-9219
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2017-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH3078122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist