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Individual

NAGAM KHUDIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
275 S BRYN MAWR AVE APT K4, BRYN MAWR, WA 19010-1901
(484) 557-7742
(484) 557-7742
Mailing address
275 S BRYN MAWR AVE APT K4, BRYN MAWR, PA 19010-4240
(484) 557-7742

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DS041355
PA
1223G0001X
General Practice Dentistry
DS041355
PA

Other

Enumeration date
06/14/2017
Last updated
06/20/2017
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