Individual
DR. LANCE P MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
904 E HIGHWAY 50, O FALLON, IL 62269-2813
(681) 632-8471
(618) 632-7130
Mailing address
904 E HIGHWAY 50, O FALLON, IL 62269-2813
(681) 632-8471
(618) 632-7130
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19025240
IL
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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