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Jimmy Liu

Dentist in Bronx, NY. Individual provider (NPI-1).

NPI number1831783976
StatusActive
Last updated in NPPESApr 24, 2023

Details

NPI
1831783976
Entity type
Individual (NPI-1)
Name
Jimmy Liu
Sex
Male
Sole proprietor
No
Enumeration date
Mar 1, 2021
Certification date
Apr 24, 2023
Last updated
Apr 24, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist062509NYYes

Practice location

111 E 210th St
Bronx, NY 10467-2401

Phone 718-920-5731

Mailing address

111 E 210th St
Bronx, NY 10467-2401

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