Individual
DR. ALAN WILLIAM LIESINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
375 PARK AVE., SUITE 7, COOS BAY, OR 97420
(541) 440-9175
(514) 673-1246
Mailing address
1813 WEST HARVARD AVE., SUITE 240, ROSEBURG, OR 97471-8708
(541) 440-9175
(541) 440-6319
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
5545
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
168369
WELFARE PROVIDER
—
Enumeration date
08/24/2006
Last updated
09/30/2013
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