Provider Demographics
NPI:1528246956
Name:LIAROS, PETER B (DDS)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:B
Last Name:LIAROS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6715 W ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2309
Mailing Address - Country:US
Mailing Address - Phone:773-229-1081
Mailing Address - Fax:773-229-1446
Practice Address - Street 1:6715 W ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2309
Practice Address - Country:US
Practice Address - Phone:773-229-1081
Practice Address - Fax:773-229-1446
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics