Individual
DR. JOHNATHON AUSTIN BUEN-GHARIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1128 LAKE ST, OAK PARK, IL 60301-1013
(708) 386-6190
Mailing address
1925 N 77TH AVE, ELMWOOD PARK, IL 60707-3613
(708) 466-5130
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.034395
IL
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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