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Individual
THAER AL AZZAWI
Active
Individual
THAER AL AZZAWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033851
IL
122300000X
Dentist
31017
TX
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
019.033851
IL
Other
Enumeration date
06/16/2015
Last updated
08/26/2023
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