Individual
DR. MATTHEW ROSS LISENBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1457 S CARSON ST STE 101, CARSON CITY, NV 89701-5240
(775) 372-9898
Mailing address
9241 EVERGREEN CANYON DR, LAS VEGAS, NV 89134-6063
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7249
NV
1223G0001X
General Practice Dentistry
Primary
7249
NV
Other
Enumeration date
07/06/2019
Last updated
05/16/2022
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