Individual
FADZANAI MUKARAKATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2661 W STEPHENSON ST, FREEPORT, IL 61032
(815) 233-1215
(815) 801-7652
Mailing address
3122 W KUNKLE BLVD, UNIT #4, FREEPORT, IL 61032
(615) 738-8743
(815) 801-7652
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028829
IL
Other
Enumeration date
08/11/2011
Last updated
03/28/2013
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