| Liberty Dental Group | |
|
6440 Brentwood Blvd Ste B Brentwood CA 94513-2190 | |
| (925) 634-3501 | |
| (925) 634-1539 |
| Full Name | Liberty Dental Group |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6440 Brentwood Blvd Ste B, Brentwood, California |
| Authorized Official Name and Position | R. Paul Krey (PRESIDENT) |
| Authorized Official Contact | 9256343501 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberty Dental Group 6440 Brentwood Blvd Ste B Brentwood CA 94513-2190 Ph: (925) 634-3501 | Liberty Dental Group 6440 Brentwood Blvd Ste B Brentwood CA 94513-2190 Ph: (925) 634-3501 |
| NPI Number | 1992955306 |
|---|---|
| Provider Enumeration Date | 09/22/2008 |
| Last Update Date | 09/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992955306 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 16705 (California) | Primary |
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