Organization
LISCIO FAMILY DENTISTRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN LISCIO (D.M.D.)
(802) 658-4873
Entity
Organization
Contact information
Practice address
369 HEINEBERG DR, COLCHESTER, VT 05446-6774
(802) 658-4873
Mailing address
369 HEINEBERG DR, COLCHESTER, VT 05446-6774
(802) 658-4873
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
016-0000868
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00002459
—
VT
Enumeration date
09/11/2007
Last updated
09/11/2007
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