SearchIllinois122300000X

Lawrence Liston, D.D.S

NPI 1568616886 · on the registry since 2008 · sole proprietor

Practice

Address
2103 E Washington St Ste 2d
Bloomington, IL 61701
Phone
(309) 663-5582
Fax
(309) 663-4683
Organisation at this address
Emil M. Verban
Tiffany Mcbride
Jsc Incorporated
Select Care Pllc
Keelan Dennis Mft
Inferred from a shared address, not stated in the registry.
Clinicians at this address
40

Registry record

Primary taxonomy
122300000X
122300000X
Licence states on file
IL
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2008-11-13

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois