Provider Demographics
NPI:1932316247
Name:LIEN, DEBORAH JEAN (DDS, MBS)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:JEAN
Last Name:LIEN
Suffix:
Gender:F
Credentials:DDS, MBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4409 ROSSI CT NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-8653
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:132 2ND AVENUE NE
Practice Address - Street 2:
Practice Address - City:BLOOMING PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55917
Practice Address - Country:US
Practice Address - Phone:507-583-6613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND95461223S0112X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery