Individual
APIS NIKRODHANOND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHDH, RDH
Contact information
Practice address
1106 NEAL AVE, JOLIET, IL 60433-2548
(815) 727-8670
Mailing address
745 W EXCHANGE ST, CRETE, IL 60417-2002
(708) 508-0227
Taxonomy
Speciality
Code
Description
License number
State
125K00000X
Advanced Practice Dental Therapist
Primary
020.013083
IL
Other
Enumeration date
10/05/2022
Last updated
10/05/2022
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