Provider Demographics
NPI:1992801468
Name:LIU, YUAN-YOUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:YUAN-YOUNG
Middle Name:
Last Name:LIU
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:YOUNG
Other - Middle Name:
Other - Last Name:LIU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD
Mailing Address - Street 1:156 TWIN HILLS DR
Mailing Address - Street 2:
Mailing Address - City:LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01106-2952
Mailing Address - Country:US
Mailing Address - Phone:413-567-7520
Mailing Address - Fax:
Practice Address - Street 1:899 SILAS DEANE HWY, 2ND FLOOR NORTH
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-4302
Practice Address - Country:US
Practice Address - Phone:860-563-1688
Practice Address - Fax:860-257-4290
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0085631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice