Organization
SECURE DENTAL VI
Active
Other names
Secure Dental Rock Island
Organization subpart
No
Provider details
NPI number
Authorized official
NAZISH HASAN JAFRI (DENTIST)
(309) 681-8888
Entity
Organization
Contact information
Practice address
106 16TH ST, UNIT #90, MOLINE, IL 61265
(309) 797-0888
Mailing address
502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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