Individual
KEITH LIBOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
790 PENLLYN BLUE BELL PIKE, BLUE BELL, PA 19422-1656
(215) 646-3900
Mailing address
790 PENLLYN BLUE BELL PIKE, BLUE BELL, PA 19422-1656
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
024178
PA
Other
Enumeration date
02/06/2007
Last updated
07/08/2007
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