Organization
ADVANCED DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NILOFER KHAN DDS (DENTIST)
(847) 814-6456
Entity
Organization
Contact information
Practice address
2335 W FULLERTON AVE, CHICAGO, IL 60647-3225
(773) 249-4700
Mailing address
2335 W FULLERTON AVE, CHICAGO, IL 60647-3225
(773) 249-4700
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028416
IL
Other
Enumeration date
08/09/2012
Last updated
03/27/2018
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