Individual
MANSI RAINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
561 W DIVERSEY PKWY STE 203, CHICAGO, IL 60614-1682
(773) 348-3668
Mailing address
651 W BRIAR PL APT 1, CHICAGO, IL 60657-8407
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031304
IL
122300000X
Dentist
103924
CA
Other
Enumeration date
07/26/2017
Last updated
07/21/2022
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