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 |