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1801142328
MOHAMEDTAREK A OMRAN
ALTON, IL
NPI
1801142328
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: IL 019028913)
Enumeration Date
2012-08-02
Last Update Date
2012-08-02
Business Address
-- MOHAMEDTAREK A OMRAN BDS
2800 COLLEGE AVE
ALTON, IL 62002-4742
Phone number: 618-474-7000
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Mailing Address
-- MOHAMEDTAREK A OMRAN BDS
2615 SPYGLASS CT APT B
EDWARDSVILLE, IL 62025-3672
Phone number: 314-546-5628
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