Individual
ANISSA CELENA ANAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
920 N ELMHURST RD, MOUNT PROSPECT, IL 60056-1126
(224) 347-3475
Mailing address
21W152 BUTTERFIELD RD, LOMBARD, IL 60148-5210
(708) 214-2572
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032578
IL
Other
Enumeration date
06/01/2020
Last updated
06/01/2020
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