Provider Demographics
NPI:1851433981
Name:LANCE, JOHN CHARLES (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:LANCE
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3015 S PROVIDENCE RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3670
Mailing Address - Country:US
Mailing Address - Phone:573-449-4900
Mailing Address - Fax:573-875-6142
Practice Address - Street 1:3015 S PROVIDENCE RD
Practice Address - Street 2:SUITE 5
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3670
Practice Address - Country:US
Practice Address - Phone:573-449-4900
Practice Address - Fax:573-875-6142
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2017-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20140216501223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery