| NPI | 1245893189 |
|---|---|
| Doing Business As | SECURE DENTAL FOSTER AVENUE |
| Entity Type | Organization |
| Authorized Contact | NAZISH JAFRI Owner, Dentist 815-708-2762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |