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Organization

TEETH SPECIALTY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LUKE LISZKA DMD (PERIODONTIST)
(403) 909-0302
Entity
Organization

Contact information

Practice address
910 JOHNNIE DODDS BLVD STE 120, MT PLEASANT, SC 29464-5909
(403) 909-0302
Mailing address
1010 OCEAN BLVD UNIT 203, ISLE OF PALMS, SC 29451-1701
(403) 909-0302

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
1223P0300X
Periodontics

Other

Enumeration date
04/03/2024
Last updated
04/03/2024
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