Individual
MARIAM BAWANY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
320 E ARMSTRONG AVE, PEORIA, IL 61603-3172
(309) 624-2411
Mailing address
2061 PENNSBURY LN, HANOVER PARK, IL 60133-6712
(773) 946-2384
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031633
IL
Other
Enumeration date
06/27/2018
Last updated
06/27/2018
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