Provider Demographics
NPI:1336335033
Name:LIEBES, DAVID ROY (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:ROY
Last Name:LIEBES
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 1:340 E NORTHFIELD RD
Mailing Address - Street 2:SUITE 1F
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-4892
Mailing Address - Country:US
Mailing Address - Phone:973-740-8919
Mailing Address - Fax:973-597-9514
Practice Address - Street 1:340 E NORTHFIELD RD
Practice Address - Street 2:SUITE 1F
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4892
Practice Address - Country:US
Practice Address - Phone:973-740-8919
Practice Address - Fax:973-597-9514
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist