Healthcare Provider Details

I. General information

NPI: 1649321019
Provider Name (Legal Business Name): JONATHAN ADAM LIEGNER DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

486 SCHOOLEYS MOUNTAIN RD
HACKETTSTOWN NJ
07840-4000
US

IV. Provider business mailing address

486 SCHOOLEYS MOUNTAIN RD
HACKETTSTOWN NJ
07840-4000
US

V. Phone/Fax

Practice location:
  • Phone: 908-850-9292
  • Fax:
Mailing address:
  • Phone: 908-850-9292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDI16529NJ
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: