Organization
KHAN'S TELEDENTISTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL KHAN (FOUNDER)
(910) 747-4360
Entity
Organization
Contact information
Practice address
1200 RENEE CT, FAYETTEVILLE, NC 28314-5815
(910) 747-4360
Mailing address
1200 RENEE CT, FAYETTEVILLE, NC 28314-5815
(910) 747-4360
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
41808696
—
NC
Enumeration date
07/28/2022
Last updated
07/28/2022
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