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Individual

DR. PHILLIP OLIVER LANCE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
BLDG 2441 21ST STREET, U S ARMY DENTAC, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633
Mailing address
BLDG 2441 21ST STREET, U S ARMY DENTAC, FORT CAMPBELL, KY 42223-5369
(270) 798-8614
(270) 798-8633

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30.023052
OH

Other

Enumeration date
09/02/2009
Last updated
09/02/2009
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