Individual
DR. JOHN THOMAS LISAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
8231 CALUMET AVE, MUNSTER, IN 46321-1703
(219) 836-0888
(219) 836-8855
Mailing address
8441 LANTERN VIEW LN, SAINT JOHN, IN 46373-9392
(219) 365-2968
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12009410A
IN
Other
Enumeration date
08/31/2006
Last updated
07/08/2007
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