| Donald R. Liberty, Dds, Inc. | |
|
4913 Golden Foothill Pkwy El Dorado Hills CA 95762-9636 | |
| (916) 941-9860 | |
| (916) 941-7165 |
| Full Name | Donald R. Liberty, Dds, Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 4913 Golden Foothill Pkwy, El Dorado Hills, California |
| Authorized Official Name and Position | Donald Robert Liberty (PRESIDENT) |
| Authorized Official Contact | 9169419860 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald R. Liberty, Dds, Inc. 4913 Golden Foothill Pkwy El Dorado Hills CA 95762-9636 Ph: (916) 941-9860 | Donald R. Liberty, Dds, Inc. 4913 Golden Foothill Pkwy El Dorado Hills CA 95762-9636 Ph: (916) 941-9860 |
| NPI Number | 1912281098 |
|---|---|
| Provider Enumeration Date | 10/06/2011 |
| Last Update Date | 10/06/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912281098 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 53466 (California) | Primary |
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