Individual
RAWAN TANNOUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
10775 ONYX DR, CARMEL, IN 46032-9494
(708) 717-4365
Mailing address
10775 ONYX DR, CARMEL, IN 46032-9494
(708) 717-4365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019031060
IL
1223G0001X
General Practice Dentistry
Primary
12013112A
IN
Other
Enumeration date
04/06/2017
Last updated
09/08/2020
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