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Individual

MOHAMMAD Z TAQVI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
545 E JOHNSON ST, FOND DU LAC, WI 54935-2856
(920) 924-9090
Mailing address
1315 W SABLE DR, ADDISON, IL 60101-5725

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032506
IL

Other

Enumeration date
06/06/2018
Last updated
11/04/2020
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