IndividualActive
Stephen Liesen, DMD
NPI 1124009329 · Dentist · Barry, IL
Provider details
- NPI number
- 1124009329
- Entity type
- Individual
- Primary specialty
- DentistDental Providers
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- License
- 19021224 (IL)
Specialties & taxonomies
Dental Providers
Practice location
750 Mortimer St
Barry, IL 62312-1247
Phone: (217) 335-2397
Fax: (217) 335-2398
Approximate (ZIP-level) locationGet directions
Mailing address
750 Mortimer St
Barry, IL 62312-1247
Registry dates
- Enumerated
- 2005-11-07
- Last updated
- 2012-10-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.