Individual
DR. MARK STEVEN LISAGOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3687 LAS POSAS RD, #180, CAMARILLO, CA 93010-1482
(805) 484-2705
(805) 484-5908
Mailing address
477 CALLE HIGUERA, CAMARILLO, CA 93010-1812
(805) 484-3928
(805) 388-1258
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
D23636
CA
Other
Enumeration date
01/18/2007
Last updated
07/08/2007
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