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Individual

ALLEN JAYWAN BAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
1200 W MAIN ST STE 9, PEORIA, IL 61606-1218
(425) 943-0242
Mailing address
1200 W MAIN ST STE 9, PEORIA, IL 61606-1218

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
319.020734
IL

Other

Enumeration date
09/01/2017
Last updated
09/01/2017
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