Individual
DR. ANDY MANCINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MBA
Contact information
Practice address
1407 N VETERANS PKWY, BLOOMINGTON, IL 61704-6630
(309) 661-2999
Mailing address
2841 N 73RD CT, ELMWOOD PARK, IL 60707-1523
(954) 789-5099
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.033956
IL
1223P0221X
Pediatric Dentistry
019.033956
IL
1223P0221X
Pediatric Dentistry
Primary
021.003238
IL
Other
Enumeration date
06/04/2008
Last updated
05/21/2024
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