Individual
MARIS J LANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
507 N HERSHEY RD STE D, BLOOMINGTON, IL 61704-3744
(309) 664-2288
Mailing address
507 N HERSHEY RD STE D, BLOOMINGTON, IL 61704-3744
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.030525
IL
Other
Enumeration date
03/16/2018
Last updated
03/16/2018
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