Individual
DR. JAYANTILAL T. MALLI
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3441 W NORTH AVE, CHICAGO, IL 60647-4841
(773) 276-6363
Mailing address
3441 W NORTH AVE, CHICAGO, IL 60647-4841
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
10/18/2005
Last updated
07/08/2007
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