Organization
MUSTAPHA HOTAIT DDS PC
Active
Other names
DOLTON DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MUSTAPHA HOTAIT (PRESIDENT)
(313) 999-8889
Entity
Organization
Contact information
Practice address
1350 E SIBLEY BLVD, SUITE 302, DOLTON, IL 60419-2965
(313) 999-8889
Mailing address
1350 E SIBLEY BLVD, SUITE 302, DOLTON, IL 60419-2965
(313) 999-8889
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9222481
—
IL
Enumeration date
12/19/2013
Last updated
12/19/2013
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