| NPI | 1235733858 |
|---|---|
| Doing Business As | SECURE DENTAL LAKE STATION |
| Entity Type | Organization |
| Authorized Contact | NAZISH HASAN JAFRI Owner Dentist 815-708-2762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-11-24 |
| Last Update Date | 2020-11-24 |