Provider Demographics
NPI:1528000403
Name:LIU, DAVID ZEN-SHAN (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ZEN-SHAN
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:PSC 557
Mailing Address - Street 2:BOX 2600
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96379
Mailing Address - Country:JP
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 557
Practice Address - Street 2:BOX 2600
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96379
Practice Address - Country:JP
Practice Address - Phone:01181611-745-7381
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0368141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice