| Liberty Dental Group | |
|
6440 Brentwood Blvd Suite B Brentwood CA 94513-5789 | |
| (925) 634-3501 | |
| (925) 634-1539 |
| Full Name | Liberty Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6440 Brentwood Blvd, Brentwood, California |
| Authorized Official Name and Position | Emily Tung (OWNER) |
| Authorized Official Contact | 3104153866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Dental Group 6440 Brentwood Blvd Suite B Brentwood CA 94513-5789 Ph: (925) 634-3501 | Liberty Dental Group 6440 Brentwood Blvd Suite B Brentwood CA 94513-5789 Ph: (925) 634-3501 |
| NPI Number | 1477005767 |
|---|---|
| Provider Enumeration Date | 11/02/2016 |
| Last Update Date | 11/02/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477005767 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 61706 (California) | Primary |
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