Individual
DR. GERALD B. LEIBER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
0 GOVERNORS AVE, SUITE 30, MEDFORD, MA 02155-3025
(781) 391-5100
(781) 391-4833
Mailing address
0 GOVERNORS AVE, SUITE 30, MEDFORD, MA 02155-3025
(781) 391-5100
(781) 391-4833
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
12008
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119049
CIGNA
MA
01
—
661277
UNITED CONCORDIA
MA
01
—
XX04930
BLUECROSS BLUE SHIELD
MA
Enumeration date
10/12/2005
Last updated
07/08/2007
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