Individual
CODY ALLEN GASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
601 BROADWAY AVE, MATTOON, IL 61938-4340
(217) 235-0556
Mailing address
8918 N COUNTY ROAD 000E, MATTOON, IL 61938-6504
(217) 962-1327
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031172
IL
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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