Individual
DR. JASON FOREMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
2916 CROSSING CT, SUITE #C, CHAMPAIGN, IL 61822-6199
(217) 352-5809
(217) 352-5812
Mailing address
2916 CROSSING CT, SUITE #C, CHAMPAIGN, IL 61822-6199
(217) 352-5809
(217) 352-5812
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019029690
IL
1223E0200X
Endodontics
Primary
021002580
IL
Other
Enumeration date
06/12/2014
Last updated
08/25/2014
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