Individual
ELFATIH EISA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8 SUNSET HILLS PROFESSIONAL CTR, EDWARDSVILLE, IL 62025-3760
(618) 831-8041
(618) 831-8042
Mailing address
8 SUNSET HILLS PROFESSIONAL CTR, EDWARDSVILLE, IL 62025-3760
(202) 957-2324
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.035367
IL
Other
Enumeration date
09/12/2024
Last updated
09/19/2024
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