Provider Demographics
NPI:1962539734
Name:LIAN, AHLEK
Entity type:Individual
Prefix:
First Name:AHLEK
Middle Name:
Last Name:LIAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:425 W 7TH ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-4581
Mailing Address - Country:US
Mailing Address - Phone:559-582-4349
Mailing Address - Fax:559-582-8064
Practice Address - Street 1:425 W 7TH ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-4581
Practice Address - Country:US
Practice Address - Phone:559-582-4349
Practice Address - Fax:559-582-8064
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA270221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice