| NPI | 1104678028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUKE LISZKA Periodontist 403-909-0302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2024-04-03 |
| Last Update Date | 2024-04-03 |