Individual
DR. JASMINE AHMAD ABDULLH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
2661 S VETERANS PKWY, SPRINGFIELD, IL 62704
(217) 280-4801
Mailing address
2632 LEMONT DR, SPRINGFIELD, IL 62704-1118
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031203
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019031203
PPO/FFS
IL
Enumeration date
07/30/2017
Last updated
07/30/2017
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