Individual
MRS. MARIA FATAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3230 W NORTH AVE, CHICAGO, IL 60647
(773) 384-4333
Mailing address
721 CHILTON LN, WILMETTE, IL 60091
(847) 256-6290
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19A14211
IL
Other
Enumeration date
09/18/2007
Last updated
09/18/2007
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