Individual
REJI THOMAS MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BDS, MDSC
Contact information
Practice address
3450 LACEY ROAD, DOWNERS GROVE, IL 60515-6700
(630) 743-4967
Mailing address
3450 LACEY ROAD, DOWNERS GROVE, IL 60515-6700
(630) 743-4967
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
136000186
IL
Other
Enumeration date
07/09/2008
Last updated
08/17/2016
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