| NPI | 1295346997 |
|---|---|
| Doing Business As | NORTH AVE. DENTAL ASSOCIATES |
| Entity Type | Organization |
| Authorized Contact | ALI M KHAN President 217-820-6487 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |