Individual
DR. LISA JANE BAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4217 E 3RD ST, BLOOMINGTON, IN 47401-5550
(812) 332-2000
Mailing address
4217 E 3RD ST, BLOOMINGTON, IN 47401-5550
(812) 332-2000
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12009106
IN
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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