Lawrence Elliott Liston, D.D.S

Dentist · Bloomington, IL

Individual Active NPI

NPI number 1568616886

Practice location

2103 E Washington St Ste 2d
Bloomington, IL 61701-4365
Phone
(309) 663-5582
Fax
(309) 663-4683

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NPI record

NPI
1568616886
Entity type
Individual (Type 1)
Enumeration date
November 13, 2008
Last updated
November 13, 2008
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019019178 IL

About Dr. Liston

Lawrence Elliott Liston, D.D.S is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 2103 E Washington St Ste 2d, Bloomington, IL 61701-4365. The NPI number 1568616886 was assigned on November 13, 2008 and the record was last updated on November 13, 2008.

Dr. Liston lists a license in the registry: #019019178 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Lawrence Elliott Liston, D.D.S?

The NPI number is 1568616886.

What is the phone number of Dr. Liston?

The phone number listed for the practice location is (309) 663-5582.

Where is Dr. Liston located?

2103 E Washington St Ste 2d, Bloomington, IL 61701-4365.

What is the taxonomy code for Dr. Liston?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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