Individual
DR. LISA MARIE BAINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1905 MONTANA DR, SUITE 30, SPRINGFIELD, IL 62704-7008
(217) 698-9300
(217) 698-9310
Mailing address
1905 MONTANA DR, SUITE 30, SPRINGFIELD, IL 62704-7008
(217) 698-9300
(217) 698-9310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.027407
IL
Other
Enumeration date
08/23/2007
Last updated
11/01/2013
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