Individual
GINA FISHBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
305 E ROLLINS RD, ROUND LAKE BEACH, IL 60073-1331
(847) 546-2900
(847) 546-6603
Mailing address
305 E ROLLINS RD, ROUND LAKE BEACH, IL 60073-1331
(847) 546-2900
(847) 546-6603
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020011397
IL
Other
Enumeration date
10/14/2009
Last updated
10/14/2009
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