Individual
DR. IMTIAZ ALI KHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3790 WEDGEWOOD LN, THE VILLAGES, FL 32162-9319
(352) 561-3554
Mailing address
44 MILEHAM DR, ORLANDO, FL 32835-4419
(689) 808-1786
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
30594
FL
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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