| Mark B Lieberman Dds Inc | |
|
11645 Wilshire Blvd Suite 1001 Los Angeles CA 90025-1708 | |
| (310) 826-7863 | |
| (310) 820-6163 |
| Full Name | Mark B Lieberman Dds Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 11645 Wilshire Blvd, Los Angeles, California |
| Authorized Official Name and Position | Mark B Lieberman (PRESIDENT) |
| Authorized Official Contact | 3108267863 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark B Lieberman Dds Inc 11645 Wilshire Blvd Suite 1001 Los Angeles CA 90025-1708 Ph: (310) 826-7863 | Mark B Lieberman Dds Inc 11645 Wilshire Blvd Suite 1001 Los Angeles CA 90025-1708 Ph: (310) 826-7863 |
| NPI Number | 1316958929 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316958929 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 22637 (California) | Primary |
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