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Organization
SECURE DENTAL IX LLC
Active
Organization
SECURE DENTAL IX LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAZISH HASAN JAFRI (DENTIST OWNER)
(309) 606-5008
Entity
Organization
Contact information
Practice address
2381 E 80TH AVE, MERRILLVILLE, IN 46410-5722
(309) 606-5008
Mailing address
502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
(309) 606-5008
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/11/2019
Last updated
01/11/2019
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