Individual
GINA L FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
B.S. R.D.H. P.H.D.H.
Contact information
Practice address
1111 THEODORE DR, CHAMPAIGN, IL 61821-6019
(217) 778-9336
Mailing address
1111 THEODORE DR, CHAMPAIGN, IL 61821-6019
(217) 778-9336
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.012599
IL
Other
Enumeration date
12/09/2020
Last updated
12/09/2020
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