Individual
MUTAZ AMINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7714 S CICERO AVE, BURBANK, IL 60459-1583
(708) 636-3368
Mailing address
6518 FOX LN, PALOS HEIGHTS, IL 60463-2277
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019031754
IL
Other
Enumeration date
07/11/2018
Last updated
07/11/2018
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