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Individual

EJAZ U TAHIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS, MS

Contact information

Practice address
2140 WESLEY AVE, BERWYN, IL 60402-1858
(708) 484-8686
(708) 484-8687
Mailing address
1 SHENANDOAH CT, BOLINGBROOK, IL 60440-1462
(630) 378-4704
(630) 378-4760

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
IL

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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