Individual
DR. NASIM KHOSHFETRAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2500 W NORTH AVE, CHICAGO, IL 60647-5202
(773) 360-1281
Mailing address
2500 W NORTH AVE, CHICAGO, IL 60647-5202
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031302
IL
Other
Enumeration date
06/11/2018
Last updated
06/11/2018
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