Provider Demographics
NPI:1629274485
Name:LIANA PUIG D.D.S.PA.
Entity Type:Organization
Organization Name:LIANA PUIG D.D.S.PA.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:LIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PUIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:305-266-0011
Mailing Address - Street 1:5870 SW 8TH ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:WEST MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33144-5052
Mailing Address - Country:US
Mailing Address - Phone:305-266-0011
Mailing Address - Fax:305-260-0770
Practice Address - Street 1:5870 SW 8TH ST
Practice Address - Street 2:SUITE 5
Practice Address - City:WEST MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33144-5052
Practice Address - Country:US
Practice Address - Phone:305-266-0011
Practice Address - Fax:305-260-0770
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN158541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty