Individual
JEFF BANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
421 IL-173, ANTIOCH, IL 60002
(224) 788-7348
Mailing address
1825 PARKER RD SE APT 1205, CONYERS, GA 30094-6301
(678) 559-4911
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034339
IL
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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