DR. Stephen T Liesen, DMD

NPI #1124009329 in Barry, Illinois

Provider Information

NPI Number: 1124009329
Entity Type: Individual
Name: DR. Stephen T Liesen, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DMD
Enumeration Date: Nov 7, 2005
Last Updated: Oct 8, 2012

Practice Location

Address: 750 MORTIMER ST
City: Barry
State: Illinois
ZIP Code: 62312-1247
Phone: (217) 335-2397

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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