# SECURE DENTAL VII

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Secure Dental Portage
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093281149
- **Authorized official:** NAZISH JAFRI DDS (DENTIST)
- **Authorized official phone:** (309) 681-8888

## Contact information

- **Practice address:** 6129 US HIGHWAY 6, PORTAGE, IN 46368-5058
- **Practice address phone:** (309) 681-8888
- **Mailing address:** 502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
- **Mailing address phone:** (309) 681-8888

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2018
- **Last updated:** 10/16/2018