Individual
JOHN LISCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
369 HEINEBERG DR, COLCHESTER, VT 05446
(802) 658-4873
(802) 863-5400
Mailing address
369 HEINEBERG DR, COLCHESTER, VT 05446
(802) 658-4873
(802) 863-5400
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
016-0000868
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0002459
—
VT
Enumeration date
08/28/2006
Last updated
07/08/2007
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