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Individual

MRS. JOSEPHINE J DABHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS DENTIST

Contact information

Practice address
1105 W PARK AVE SUITE 8, PARK DENTAL, LIBERTYVILLE, IL 60048
(847) 362-4740
(847) 362-4764
Mailing address
1105 W PARK AVE SUITE 8, PARK DENTAL, LIBERTYVILLE, IL 60048
(847) 362-4740
(847) 362-4764

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019024462
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019024462
LICENSE #
IL
01
319013054
CONTROL SUBSTANCE LICENSE
Enumeration date
09/14/2006
Last updated
05/18/2023
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