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Individual

RAVI AMIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
720 COG CIR STE H, CRYSTAL LAKE, IL 60014-7301
(779) 220-4396
Mailing address
720 COG CIR STE H, CRYSTAL LAKE, IL 60014-7301
(779) 220-4396

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031878
IL

Other

Enumeration date
09/22/2018
Last updated
09/22/2018
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