Individual
FEROSS W ATALLAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
561 E LINCOLN HWY, NEW LENOX, IL 60451-1909
(708) 983-5908
Mailing address
9046 WINDSOR DR, PALOS HILLS, IL 60465-1168
(708) 983-5908
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019033831
IL
1223G0001X
General Practice Dentistry
019033831
IL
Other
Enumeration date
08/08/2022
Last updated
08/08/2022
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