DR. Jeremy Shane Lansford, D.M.D.

NPI #1174577811 in Suffield, Connecticut

Provider Information

NPI Number: 1174577811
Entity Type: Individual
Name: DR. Jeremy Shane Lansford, D.M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: May 19, 2006
Last Updated: Mar 31, 2009

Practice Location

Address: 180 MARBERN DR
City: Suffield
State: Connecticut
ZIP Code: 06078-1535
Phone: (210) 455-5571

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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