Provider Demographics
NPI:1790952984
Name:EDWARD C LIU DDS PLLC
Entity Type:Organization
Organization Name:EDWARD C LIU DDS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-699-2985
Mailing Address - Street 1:2123 AURELIUS RD
Mailing Address - Street 2:
Mailing Address - City:HOLT
Mailing Address - State:MI
Mailing Address - Zip Code:48842-1333
Mailing Address - Country:US
Mailing Address - Phone:517-699-2985
Mailing Address - Fax:517-699-2205
Practice Address - Street 1:2123 AURELIUS RD
Practice Address - Street 2:
Practice Address - City:HOLT
Practice Address - State:MI
Practice Address - Zip Code:48842-1333
Practice Address - Country:US
Practice Address - Phone:517-699-2985
Practice Address - Fax:517-699-2205
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-15
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901018000261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental