Individual
KENNETH JOHN LIDDIARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2025 W US HIGHWAY 50 STE A100, PUEBLO, CO 81008-1571
(719) 542-2472
(719) 542-6435
Mailing address
2025 W US HIGHWAY 50 STE A100, PUEBLO, CO 81008-1571
(719) 542-2472
(719) 542-6435
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
00203000
CO
Other
Enumeration date
05/01/2006
Last updated
10/23/2020
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