Organization
BARRY DENTAL CLINIC
Active
Other names
STEPHEN T LIESEN DMD LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN T LIESEN DMD (DENTIST/OWNER)
(217) 335-2397
Entity
Organization
Contact information
Practice address
750 MORTIMER ST, BARRY, IL 62312-1247
(217) 335-2397
(217) 335-2398
Mailing address
750 MORTIMER ST, BARRY, IL 62312-1247
(217) 335-2397
(217) 335-2398
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019021224
IL
Other
Enumeration date
03/19/2008
Last updated
10/22/2012
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