Individual
DR. HATIMALI IMTIAZ HUSAIN MITHAIWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1010 W US ROUTE 6, MORRIS, IL 60450-8942
(815) 942-0010
Mailing address
1010 W US ROUTE 6, MORRIS, IL 60450-8942
(815) 942-0010
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034773
IL
Other
Enumeration date
01/31/2024
Last updated
01/31/2024
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