Organization
SECURE DENTAL VIII
Active
Other names
Secure Dental Hammond
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NAZISH JAFRI DDS (DENTSIT)
(309) 681-8888
Entity
Organization
Contact information
Practice address
7905 INDIANAPOLIS BLVD, INDIANAN, IN 46324
(309) 681-8888
Mailing address
502 RIVERSIDE DR, EAST PEORIA, IL 61611-2068
(309) 681-8888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/17/2018
Last updated
10/17/2018
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