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General NPI Number Information
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NPI Number | 1083749253
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Entity Type | Individual
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Provider Name | JAMEEL AHMAD AFTAB DMD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 6162 RIDGE AVE
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City | ROXBOROUGH
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State | PA
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Zip | 19128
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Country | US
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Telephone | 215-483-1900
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Fax |
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Provider Business Mailing Address
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Address Line | 604 S MAIN ST
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City | DAVISON
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State | MI
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Zip | 48423-1814
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Country | US
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Telephone | 810-653-1500
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DS037002
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License Number State | PA
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