Individual
TERRY BURRITT LESAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1330 E MAIN, LAMONI, IA 50140
(641) 784-6059
Mailing address
1330 E MAIN, LAMONI, IA 50140
(641) 784-6059
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6830
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0197251
—
IA
Enumeration date
08/16/2006
Last updated
07/08/2007
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