Individual
DR. LATOI RAPHAEL THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
430 DIXIE HWY, CHICAGO HEIGHTS, IL 60411-1799
(708) 808-4950
Mailing address
16 HICKORY CT, CALUMET CITY, IL 60409-5013
(312) 391-1913
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028142
IL
Other
Enumeration date
02/05/2010
Last updated
11/13/2020
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