NPI | 1811535404 |
---|---|
Doing Business As | SECURE DENTAL ASHLAND AVENUE |
Entity Type | Organization |
Authorized Contact | NAZISH HASAN JAFRI Dentist 309-681-8888 |
Organization Subpart ? | No |
Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
Enumeration Date | 2019-12-15 |
Last Update Date | 2019-12-15 |