Individual
DR. LANCE KNIGHT SKINKYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
280 S ADDISON ST, BENSENVILLE, IL 60106-2624
(630) 544-9637
Mailing address
280 S ADDISON ST, BENSENVILLE, IL 60106-2624
(630) 544-9637
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019028270
IL
1223G0001X
General Practice Dentistry
Primary
019028270
IL
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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