Individual
MAITHILEE A JANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DENTIST
Contact information
Practice address
109 E MAPLE ST, GILLESPIE, IL 62033-1473
(217) 839-1526
Mailing address
1516 SEVEN PINES RD APT H, SPRINGFIELD, IL 62704-6615
(657) 272-1074
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033451
IL
Other
Enumeration date
11/15/2021
Last updated
11/15/2021
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