Provider Demographics
NPI:1841255205
Name:LISS, DAVID (DMD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:LISS
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 1:2973 MEREDITH PL
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2258
Mailing Address - Country:US
Mailing Address - Phone:215-588-2884
Mailing Address - Fax:
Practice Address - Street 1:12 PENNS TRAIL
Practice Address - Street 2:SUITE 154
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-3438
Practice Address - Country:US
Practice Address - Phone:888-964-6681
Practice Address - Fax:888-662-0859
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS026836L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist