Provider Demographics
NPI:1669564019
Name:LIU, CHRISTINA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:
Last Name:LIU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4803
Mailing Address - Country:US
Mailing Address - Phone:516-477-0581
Mailing Address - Fax:
Practice Address - Street 1:928 EVERGREEN DR
Practice Address - Street 2:
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4803
Practice Address - Country:US
Practice Address - Phone:516-477-0581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC99581223G0001X
NY0446101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice