Provider Demographics
NPI:1770863441
Name:DANIEL V. LIBERMAN DDS
Entity Type:Organization
Organization Name:DANIEL V. LIBERMAN DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:V
Authorized Official - Last Name:LIBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-252-0505
Mailing Address - Street 1:18500 VIA PRINCESSA STE 1
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91387-8325
Mailing Address - Country:US
Mailing Address - Phone:661-252-0505
Mailing Address - Fax:661-252-0504
Practice Address - Street 1:18500 VIA PRINCESSA STE 1
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91387-8325
Practice Address - Country:US
Practice Address - Phone:661-252-0505
Practice Address - Fax:661-252-0504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-25
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA313091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty