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Individual

CHASE LISKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
18223 CARSON CT NW, ELK RIVER, MN 55330-2733
(763) 441-7030
Mailing address
18223 CARSON CT NW, ELK RIVER, MN 55330-2733

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D14068
MN

Other

Enumeration date
06/20/2018
Last updated
06/20/2018
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