Individual
AISHA Y MULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2800 COLLEGE AVE, ALTON, IL 62002-4700
(618) 474-7000
Mailing address
288 HICKORY HEDGE DR, BALLWIN, MO 63021-5731
(573) 529-7642
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.034391
IL
Other
Enumeration date
09/11/2023
Last updated
09/13/2023
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