Individual
DR. GAURAV MALIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
124 E HIGHLAND DR, FORSYTH, IL 62535-8906
(217) 615-0020
Mailing address
141 CAMBRIDGE BLVD APT NO4, AMHERST, NY 14226-3056
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019031252
IL
Other
Enumeration date
07/10/2017
Last updated
07/10/2017
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