Organization
SECURE DENTAL VII
Active
Other names
Secure Dental Portage
Organization subpart
No
Provider details
NPI number
Authorized official
NAZISH JAFRI DDS (DENTIST)
(309) 681-8888
Entity
Organization
Contact information
Practice address
6129 US HIGHWAY 6, PORTAGE, IN 46368-5058
(309) 681-8888
Mailing address
502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
(309) 681-8888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/16/2018
Last updated
10/16/2018
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