Individual
LUCIA JIARDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10 HEARTLAND DR STE C, BLOOMINGTON, IL 61704-7775
(309) 663-1721
Mailing address
10 HEARTLAND DR STE C, BLOOMINGTON, IL 61704-7775
(309) 663-1721
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.033324
IL
Other
Enumeration date
08/26/2021
Last updated
08/26/2021
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