Individual
DR. WILLIAM CLAY LISENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,P.C.
Contact information
Practice address
6336 PEAKE RD, MACON, GA 31210-3960
(478) 330-5130
(478) 405-7897
Mailing address
6336 PEAKE RD, MACON, GA 31210-3960
(478) 330-5130
(478) 405-7897
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
01073
GA
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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