Individual
HUMA COVUT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
5876 E STATE ST, ROCKFORD, IL 61108-2428
(815) 901-1044
Mailing address
5876 E STATE ST, ROCKFORD, IL 61108-2428
(815) 901-1044
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.035272
IL
Other
Enumeration date
07/08/2024
Last updated
08/22/2025
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