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Individual

AZBA KHAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
639 MOUNT PROSPECT AVE, NEWARK, NJ 07104-3109
(973) 481-3900
Mailing address
503 MORRIS AVE, BOONTON, NJ 07005-1319

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
22DI02939300
NJ
1223G0001X
General Practice Dentistry
Primary
40152
TX

Other

Enumeration date
12/01/2022
Last updated
12/15/2023
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