Provider Demographics
NPI:1427010537
Name:MADERA-LIEBERUM, MARCEY L (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARCEY
Middle Name:L
Last Name:MADERA-LIEBERUM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2867 WASHINGTON RD
Mailing Address - Street 2:PO BOX 1278
Mailing Address - City:MC MURRAY
Mailing Address - State:PA
Mailing Address - Zip Code:15317-3282
Mailing Address - Country:US
Mailing Address - Phone:724-941-9600
Mailing Address - Fax:724-941-7448
Practice Address - Street 1:2867 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MC MURRAY
Practice Address - State:PA
Practice Address - Zip Code:15317-3282
Practice Address - Country:US
Practice Address - Phone:724-941-9600
Practice Address - Fax:724-941-7448
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2012-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0304571223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics