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NPI 1811096282

IndividualActive

John Liedtke, DDS

NPI 1811096282 · Dentist · Garrison, TX

Provider details

NPI number: 1811096282
Entity type: Individual
Primary specialty: DentistDental Providers
Credential: DDS
Sex: Male
Sole proprietor: No
License: 10424 (TX)

Specialties & taxonomies

DentistPrimary122300000XLicense 10424 (TX)
Dental Providers

Practice location

593 Hwy 59 South

Garrison, TX 75996-0905

Phone: (936) 347-2163

Fax: (936) 347-2088

More TX providers

Mailing address

Po Box 905

Garrison, TX 75946-0905

Registry dates

Enumerated: 2006-09-22
Last updated: 2007-07-08

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.

John Liedtke, DDS — NPI 1811096282, Garrison, TX | NPI Central