Individual
MRS. LISA K MENEFEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
420 N WEST ST, ODON, IN 47562-1036
(812) 323-9970
(812) 323-9961
Mailing address
PO BOX 1150, BLOOMINGTON, IN 47402-1150
(812) 323-9970
(812) 323-9961
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010591
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200459180
—
IN
Enumeration date
11/21/2006
Last updated
07/08/2007
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