Individual
DR. ANKIT MALHOTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
7310 N VILLA LAKE DR STE B, PEORIA, IL 61614
(309) 691-9072
Mailing address
5805 N CYPRESS DR APT 3103, PEORIA, IL 61615-8408
(201) 823-7448
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031834
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2018
Last updated
08/14/2018
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