Individual
MANGAYARKARASI MATHIYAZHAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1403 W GLEN AVE, PEORIA, IL 61614-4705
(888) 988-4066
(847) 496-7603
Mailing address
2050 E ALGONQUIN RD, SUITE 610, SCHAUMBURG, IL 60173-4144
(888) 988-4066
(847) 496-7603
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.029161
IL
Other
Enumeration date
07/25/2012
Last updated
07/25/2012
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