Individual
NILOUFAR GHAZAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
16620 W 159TH ST, LOCKPORT, IL 60441-8012
(815) 552-2360
(815) 552-2963
Mailing address
16620 W 159TH ST, LOCKPORT, IL 60441-8012
(815) 552-2360
(815) 552-2963
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031246
IL
Other
Enumeration date
07/10/2017
Last updated
07/21/2022
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