Individual
ANDREW LORD BASNET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-3923
Mailing address
1201 W ADAMS ST APT 906, CHICAGO, IL 60607-2949
(217) 461-1874
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.037233
IL
Other
Enumeration date
06/18/2026
Last updated
06/18/2026
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