Individual
PROF. MARTIN F. LAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MSD
Contact information
Practice address
2800 COLLEGE AVE - BLDG. 263, SOUTHERN ILLINOIS UNIVERSITY, SCHOOL OF DENTAL MEDICINE, ALTON, IL 62002-4700
(618) 474-7072
(618) 474-7141
Mailing address
2800 COLLEGE AVE - BLDG. 284, SOUTHERN ILLINOIS UNIVERSITY, SCHOOL OF DENTAL MEDICINE, ALTON, IL 62002-4700
(618) 474-7072
(618) 474-7141
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.021447
IL
1223G0001X
General Practice Dentistry
DN8561
FL
Other
Enumeration date
07/10/2013
Last updated
07/10/2013
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