Provider Demographics
NPI:1689702607
Name:LIU, PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:
Last Name:LIU
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 1:3301 N MILLER RD
Mailing Address - Street 2:SUITE 151
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6431
Mailing Address - Country:US
Mailing Address - Phone:480-949-5579
Mailing Address - Fax:480-949-7309
Practice Address - Street 1:3301 N MILLER RD
Practice Address - Street 2:SUITE 151
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6431
Practice Address - Country:US
Practice Address - Phone:480-949-5579
Practice Address - Fax:480-949-7309
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD50801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice