Organization
TEETH DS ISLE OF PALMS
Active
Parent organization
TEETH DS ISLE OF PALMS
Other names
Teeth DS IOP Endo Perio
Organization subpart
Yes
Provider details
NPI number
Legal business name
TEETH DS ISLE OF PALMS
Authorized official
LUKE LISZKA DMD (PERIODONTIST)
(843) 886-6461
Entity
Organization
Contact information
Practice address
15 21ST AVE, ISLE OF PALMS, SC 29451-2384
(843) 886-6461
Mailing address
15 21ST AVE, ISLE OF PALMS, SC 29451-2384
(843) 886-6461
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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