Healthcare Provider Details

I. General information

NPI: 1629972914
Provider Name (Legal Business Name): NICHOLAS LIAS DMD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E LANCASTER AVE STE 203W
WYNNEWOOD PA
19096-3447
US

IV. Provider business mailing address

110 BENTLEY AVE
BALA CYNWYD PA
19004-2806
US

V. Phone/Fax

Practice location:
  • Phone: 610-642-0259
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. NICHOLAS LIAS
Title or Position: OWNER, DENTIST
Credential: DMD
Phone: 267-608-4790