Individual
DR. LANCE J. SKIDMORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.,M.S.
Contact information
Practice address
2014 W BEAUREGARD AVE, SAN ANGELO, TX 76901-3813
(325) 716-9597
Mailing address
2014 W BEAUREGARD AVE, SAN ANGELO, TX 76901-3813
(325) 716-9597
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
23788
TX
Other
Enumeration date
12/15/2006
Last updated
08/13/2008
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