Individual
DR. LEE LARUE BENNETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1221 E CONDIT ST, DECATUR, IL 62521-1405
(217) 423-9930
(217) 233-5787
Mailing address
1221 E CONDIT ST, DECATUR, IL 62521-1405
(217) 423-9930
(217) 233-5787
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
04/23/2007
Last updated
07/08/2007
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