MRS. Mary Ann Southerlan, RDH, PHDH

NPI #1235732579 in Lincoln, Illinois

Provider Information

NPI Number: 1235732579
Entity Type: Individual
Name: MRS. Mary Ann Southerlan, RDH, PHDH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dental Hygienist
Credential: RDH, PHDH
Enumeration Date: Nov 19, 2020
Last Updated: Nov 19, 2020

Practice Location

Address: 109 3RD ST
City: Lincoln
State: Illinois
ZIP Code: 62656-2604
Phone: (217) 735-2317

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dental Hygienist	124Q00000X	Primary

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Organizations

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