Organization
COMMUNITY DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA MARIE LENISKI DDS, MSD (CLINIC DIRECTOR)
(260) 768-7918
Entity
Organization
Contact information
Practice address
7750 W 200 S, TOPEKA, IN 46571-9436
(260) 768-7918
(260) 768-7983
Mailing address
7750 W 200 S, TOPEKA, IN 46571-9436
(260) 768-7918
(260) 768-7983
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2010
Last updated
03/16/2010
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