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Individual

DR. ERNEST PETER LIACOPULOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
500 COLONY RD, GARDNER, MA 01440-4238
(978) 632-2000
Mailing address
16 RYAN RD, SHREWSBURY, MA 01545-3199
(508) 845-2158

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN17582
MA
126800000X
Dental Assistant

Other

Enumeration date
06/24/2013
Last updated
06/24/2013
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