Individual
BAMINI BLAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
774 W BARTLETT RD, BARTLETT, IL 60103-4482
(630) 213-3636
(630) 213-3633
Mailing address
774 W BARTLETT RD, BARTLETT, IL 60103-4482
(630) 213-3636
(630) 213-3633
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
021002113
IL
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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