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Organization
SECURE DENTAL VI
Active
Organization
SECURE DENTAL VI
Active
Other names
Secure Dental Ashland Avenue
Organization subpart
No
Provider details
NPI number
Authorized official
NAZISH HASAN JAFRI (DENTIST)
(309) 681-8888
Entity
Organization
Contact information
Practice address
3540 N ASHLAND AVE, CHICAGO, IL 60657-1314
(309) 606-5008
Mailing address
502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
(309) 681-8888
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/15/2019
Last updated
12/15/2019
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