Provider Demographics
NPI:1447374756
Name:LIANG, JOHN J (DMD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:J
Last Name:LIANG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:NEW HARTFORD
Mailing Address - State:NY
Mailing Address - Zip Code:13413-3809
Mailing Address - Country:US
Mailing Address - Phone:315-737-5650
Mailing Address - Fax:
Practice Address - Street 1:2813 GENESEE ST
Practice Address - Street 2:
Practice Address - City:UTICA
Practice Address - State:NY
Practice Address - Zip Code:13501-6525
Practice Address - Country:US
Practice Address - Phone:315-735-6700
Practice Address - Fax:315-732-7147
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039277-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice