Provider Demographics
NPI:1922277284
Name:DR SIDNEY LIBFRAIND
Entity Type:Organization
Organization Name:DR SIDNEY LIBFRAIND
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SIDNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBFRAIND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-266-9286
Mailing Address - Street 1:106 N 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-8093
Mailing Address - Country:US
Mailing Address - Phone:919-266-9286
Mailing Address - Fax:919-266-0373
Practice Address - Street 1:106 N 1ST AVE
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-8093
Practice Address - Country:US
Practice Address - Phone:919-266-9286
Practice Address - Fax:919-266-0373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC55601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty