Individual
DR. MICHAEL JOHN MABBORANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
10 S LARKIN AVE, JOLIET, IL 60436-1243
(815) 773-6200
(815) 773-6201
Mailing address
430 W ERIE ST, STE 500, CHICAGO, IL 60610-6914
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
06/22/2007
Last updated
07/08/2007
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