Individual
MATAN MOSHE FARHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
719 BARRON BLVD, GRAYSLAKE, IL 60030-3314
(847) 986-6724
(312) 561-4750
Mailing address
290 W ALAMEDA AVE APT 634, DENVER, CO 80223-2199
(224) 374-9411
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
319.021509
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DEN.00204981
CO
Other
Enumeration date
08/07/2019
Last updated
03/30/2022
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