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Individual

SARAH SOURIALLE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
3014 S HALSTED ST, CHICAGO, IL 60608-5805
(312) 291-9283
Mailing address
9 SAINT RAPHAEL, LAGUNA NIGUEL, CA 92677-2761
(909) 732-7487

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034499
IL

Other

Enumeration date
07/14/2023
Last updated
07/14/2023
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