Organization
LISA H SIDDALL DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA H SIDDALL DDS (PRESIDENT)
(231) 256-9142
Entity
Organization
Contact information
Practice address
407 S MAIN, LELAND, MI 49634
(231) 256-9142
(231) 256-9131
Mailing address
PO BOX 1133, 407 S MAIN, LELAND, MI 49634
(231) 256-9142
(231) 256-9131
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
16320
MI
Other
Enumeration date
02/01/2007
Last updated
08/22/2020
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