# COMMUNITY DENTAL CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114241494
- **Authorized official:** DR. LISA MARIE LENISKI DDS, MSD (CLINIC DIRECTOR)
- **Authorized official phone:** (260) 768-7918

## Contact information

- **Practice address:** 7750 W 200 S, TOPEKA, IN 46571-9436
- **Practice address phone:** (260) 768-7918
- **Practice address fax:** (260) 768-7983
- **Mailing address:** 7750 W 200 S, TOPEKA, IN 46571-9436
- **Mailing address phone:** (260) 768-7918
- **Mailing address fax:** (260) 768-7983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/16/2010
- **Last updated:** 03/16/2010