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Individual

GARY LEE CUNNINGHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.M.D.

Contact information

Practice address
5 LAUREL CT., WASHINGTON, IL 61571
(309) 688-7321
(309) 688-7942
Mailing address
5 LAUREL CT., WASHINGTON, IL 61616
(309) 688-7321
(309) 688-7942

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
01915685
IL

Other

Enumeration date
01/30/2007
Last updated
07/08/2007
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