Individual
NIMRATA PANDHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030460
IL
Other
Enumeration date
09/17/2015
Last updated
07/15/2016
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