Individual
DR. KYLE LISENBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
303 N KEENE ST, SUITE 208, COLUMBIA, MO 65201-6623
(573) 571-2222
(573) 817-2888
Mailing address
303 N KEENE ST, SUITE 208, COLUMBIA, MO 65201-6623
(573) 571-2222
(573) 817-2888
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2008006645 M
MO
Other
Enumeration date
03/07/2008
Last updated
03/07/2008
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