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Individual

LANE GARY STILLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
139 NORTH MAIN STREET, GEORGE, IA 51237
(712) 475-3871
Mailing address
139 NORTH MAIN STREET, GEORGE, IA 51237
(712) 475-3871

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
06499
IA

Other

Enumeration date
06/26/2007
Last updated
07/08/2007
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