Individual
MOMINA F RAHMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
110 N LARKIN AVE, JOLIET, IL 60435-6603
(815) 310-3220
Mailing address
110 N LARKIN AVE, JOLIET, IL 60435-6603
(815) 310-3220
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031780
IL
Other
Enumeration date
08/21/2018
Last updated
08/21/2018
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