DR. John David Liedtke, DDS

NPI #1811096282 in Garrison, Texas

Provider Information

NPI Number: 1811096282
Entity Type: Individual
Name: DR. John David Liedtke, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Sep 22, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 593 HWY 59 SOUTH
City: Garrison
State: Texas
ZIP Code: 75996-0905
Phone: (936) 347-2163

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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