Individual
DR. IAN LIEBERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
491 DELAWARE ST, TONAWANDA, NY 14150-5350
(716) 693-1299
Mailing address
491 DELAWARE ST, TONAWANDA, NY 14150-5350
(716) 693-1299
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
061857
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/03/2020
Last updated
08/18/2021
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