Individual
JONATHAN FLAKSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
430 BARRON BLVD, GRAYSLAKE, IL 60030-1666
(847) 962-1057
Mailing address
430 BARRON BLVD, GRAYSLAKE, IL 60030-1666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030839
IL
122300000X
Dentist
DN22116
FL
Other
Enumeration date
10/07/2016
Last updated
11/02/2016
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