Individual
AYESHA SULTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1845 WALNUT ST STE 950, PHILADELPHIA, PA 19103-4709
(215) 567-0110
Mailing address
1613 FORDHAM CT, NAPERVILLE, IL 60565-2998
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS040526
PA
Other
Enumeration date
06/10/2015
Last updated
11/02/2017
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