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General NPI Number Information
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NPI Number | 1386213494
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Entity Type | Organization
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Legal Business Name | ANDREW L. LIEBERMAN DMD LLC
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Dates
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Enumeration Date | 06/22/2021
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Last Update Date | 08/19/2021
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Provider Practice Location Address
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Address Line | 14 S BRYN MAWR AVE STE 200
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City | BRYN MAWR
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State | PA
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Zip | 19010-3216
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Country | US
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Telephone | 610-527-6700
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Fax |
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Provider Business Mailing Address
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Address Line | 14 S BRYN MAWR AVE STE 200
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City | BRYN MAWR
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State | PA
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Zip | 19010-3216
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. ANDREW L LIEBERMAN
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Credential | DMD
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Telephone | 610-527-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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