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Individual

JOHN W LANDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
496 SOUTHLAND DR, LEXINGTON, KY 40503-1827
(859) 288-2425
(859) 721-3918
Mailing address
496 SOUTHLAND DR, LEXINGTON, KY 40503-1827
(859) 288-2392
(859) 721-3918

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
7231
KY
1223G0001X
General Practice Dentistry
Primary
7231
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
60072311
KY
Enumeration date
01/05/2009
Last updated
05/30/2019
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