Individual
DR. FABIAN DAVID LATOCHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
202 S GREENLEAF ST, SUITE A, GURNEE, IL 60031-3399
(847) 623-2830
(847) 623-1534
Mailing address
13380 W 21ST ST, WADSWORTH, IL 60083-9474
(847) 746-7517
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
IL
Other
Enumeration date
05/04/2006
Last updated
07/08/2007
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