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General NPI Number Information
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NPI Number | 1124676507
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Entity Type | Individual
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Provider Name | NAJEEB M ABUFARHA DMD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2019
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Last Update Date | 08/29/2019
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Provider Practice Location Address
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Address Line | 7409 WOODRIDGE DR STE B
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City | WOODRIDGE
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State | IL
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Zip | 60517-2249
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Country | US
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Telephone | 773-546-8648
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Fax |
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Provider Business Mailing Address
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Address Line | 2825 GABRIELLA ST UNIT 601
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City | DOWNERS GROVE
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State | IL
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Zip | 60515-3991
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Country | US
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Telephone | 773-546-8648
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019032298
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License Number State | IL
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