Individual
DR. FABIAN GREGORY HOSEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.S.
Contact information
Practice address
3306 W CHARTWELL RD, PEORIA, IL 61614-2322
(309) 690-0011
(309) 690-0022
Mailing address
3306 W CHARTWELL RD, PEORIA, IL 61614-2322
(309) 690-0011
(309) 690-0022
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19027263
IL
122300000X
Dentist
21461
TX
1223E0200X
Endodontics
009566
CT
1223E0200X
Endodontics
Primary
021002221
IL
Other
Enumeration date
03/22/2007
Last updated
12/01/2023
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