Individual
DR. MARVIN AMAYUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1100 NERGE RD, STE 209, ELK GROVE VILLAGE, IL 60007-3240
(847) 891-6600
Mailing address
1100 NERGE RD, STE 209, ELK GROVE VILLAGE, IL 60007-3240
(847) 891-6600
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.026102
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019026102
—
IL
Enumeration date
08/12/2006
Last updated
02/26/2012
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