Provider Demographics
NPI:1568565950
Name:DO, LIEM DUY (DDS)
Entity Type:Individual
Prefix:
First Name:LIEM
Middle Name:DUY
Last Name:DO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13510 NE 84TH ST
Mailing Address - Street 2:#105
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682
Mailing Address - Country:US
Mailing Address - Phone:360-696-0000
Mailing Address - Fax:360-896-6264
Practice Address - Street 1:13510 NE 84TH ST
Practice Address - Street 2:SUITE #105
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-3092
Practice Address - Country:US
Practice Address - Phone:360-696-0000
Practice Address - Fax:360-896-6264
Is Sole Proprietor?:No
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE81591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice