Individual
DR. MIR WAHAJUDDIN ALI KHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
601 W CENTRAL RD STE 4, MT PROSPECT, IL 60056-2379
(847) 392-2457
Mailing address
601 W CENTRAL RD STE 4, MT PROSPECT, IL 60056-2379
(847) 392-2457
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019029566
IL
Other
Enumeration date
08/27/2013
Last updated
08/27/2013
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