Individual
MOHIT SATISH JETHANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
411 KEOKUK ST, LINCOLN, IL 62656-1726
(217) 732-8818
Mailing address
2802 E LINCOLN ST APT 2A, BLOOMINGTON, IL 61704-6153
(424) 325-9393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019033792
IL
Other
Enumeration date
10/10/2018
Last updated
01/14/2023
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