Provider Demographics
NPI:1275626343
Name:LIEBERMAN, LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:LIEBERMAN
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 1:289 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:SADDLE BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:07663
Mailing Address - Country:US
Mailing Address - Phone:201-843-7064
Mailing Address - Fax:201-843-4709
Practice Address - Street 1:289 MARKET ST
Practice Address - Street 2:
Practice Address - City:SADDLE BROOK
Practice Address - State:NJ
Practice Address - Zip Code:07663
Practice Address - Country:US
Practice Address - Phone:201-843-7064
Practice Address - Fax:201-843-4709
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ2201009774001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics