Individual
DR. ADDISON LENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
519 N PLUM ST, PONTIAC, IL 61764-1818
(815) 844-6184
Mailing address
519 N PLUM ST, PONTIAC, IL 61764-1818
(815) 844-6184
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030379
IL
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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