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General NPI Number Information
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NPI Number | 1952644510
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Entity Type | Organization
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Legal Business Name | GARY LIBERATI, DMD AND ASSOCIATES, PC
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Dates
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Enumeration Date | 04/02/2013
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 509 LONG RD
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City | PITTSBURGH
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State | PA
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Zip | 15235-4365
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Country | US
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Telephone | 412-243-7117
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Fax | 412-243-7173
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Provider Business Mailing Address
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Address Line | 509 LONG RD
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City | PITTSBURGH
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State | PA
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Zip | 15235-4365
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Country | US
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Telephone | 412-243-7117
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Fax | 412-243-7173
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Authorized Official
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Title or Position | OWNER/CEO
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Name | DR. GARY R. LIBERATI
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Credential | DMD
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Telephone | 412-795-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | DS021430-L
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License Number State | PA
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