Provider Demographics
NPI:1487783320
Name:LIEBERMAN, DANIEL A, (DMD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:A,
Last Name:LIEBERMAN
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 1:140 LURING DR.
Mailing Address - Street 2:SUITE 'B'
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262
Mailing Address - Country:US
Mailing Address - Phone:760-778-2777
Mailing Address - Fax:760-778-2779
Practice Address - Street 1:140 LURING DR.
Practice Address - Street 2:SUITE 'B'
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262
Practice Address - Country:US
Practice Address - Phone:760-778-2777
Practice Address - Fax:760-778-2779
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA332121223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice