Individual
DR. ABDUL JABBAR KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD, MS
Contact information
Practice address
50 JUDSON ST, MALDEN, MA 02148-7023
(470) 272-4607
Mailing address
2243 PARK AVE, PEARLAND, TX 77581-4216
(470) 272-4607
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2018007148
MO
1223G0001X
General Practice Dentistry
2018007148
MO
Other
Enumeration date
02/28/2018
Last updated
08/14/2020
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