Provider Demographics
NPI:1467691378
Name:RICK Y. LIEU, D.D.S.,PLLC
Entity Type:Organization
Organization Name:RICK Y. LIEU, D.D.S.,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:Y
Authorized Official - Last Name:LIEU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:253-845-0558
Mailing Address - Street 1:8604 112TH ST E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-3857
Mailing Address - Country:US
Mailing Address - Phone:253-845-0558
Mailing Address - Fax:253-841-0980
Practice Address - Street 1:8604 112TH ST E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-3857
Practice Address - Country:US
Practice Address - Phone:253-845-0558
Practice Address - Fax:253-841-0980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000088591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty