Individual
GAITH KHATLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2241 THEODORE ST, CREST HILL, IL 60403-1881
(815) 741-1700
Mailing address
1127 WASHINGTON BLVD APT 3I, OAK PARK, IL 60302-3660
(206) 375-7915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031631
IL
Other
Enumeration date
06/07/2018
Last updated
05/22/2019
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