Individual
MRS. AIDA FATUSIC BOSNJAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH, OMT,BBP
Contact information
Practice address
825 S WAUKEGAN RD, LAKE FOREST, IL 60045-2696
(847) 234-4800
Mailing address
825 S WAUKEGAN RD, LAKE FOREST, IL 60045-2696
(847) 234-4800
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.010057
IL
Other
Enumeration date
02/11/2018
Last updated
02/11/2018
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