| Todd C. Liston DDS, MS, PC | |
|
469 Medical Dr Suite 202 Bountiful UT 84010-4900 | |
| (801) 299-8531 | |
| (801) 299-9667 |
| Full Name | Todd C. Liston DDS, MS, PC |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 469 Medical Dr, Bountiful, Utah |
| Authorized Official Name and Position | Todd C. Liston (ORAL AND MAXILLOFACIAL SURGEON) |
| Authorized Official Contact | 8017790506 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Todd C. Liston DDS, MS, PC 2297 N Hill Field Rd Building A, Suite 105 Layton UT 84041-6920 Ph: (801) 779-0506 | Todd C. Liston DDS, MS, PC 469 Medical Dr Suite 202 Bountiful UT 84010-4900 Ph: (801) 299-8531 |
| NPI Number | 1205098324 |
|---|---|
| Provider Enumeration Date | 06/30/2008 |
| Last Update Date | 08/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205098324 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 260605 (Utah) | Primary |
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