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General NPI Number Information
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NPI Number | 1124862370
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Entity Type | Individual
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Provider Name | SAFIA VOHRA DDS
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Gender | Female
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Dates
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Enumeration Date | 06/22/2024
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Last Update Date | 11/24/2024
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Provider Practice Location Address
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Address Line | 7601 PERSHING BLVD
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City | KENOSHA
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State | WI
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Zip | 53142-4321
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Country | US
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Telephone | 262-694-1100
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Fax |
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Provider Business Mailing Address
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Address Line | 545 N 17TH ST APT 15
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City | MILWAUKEE
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State | WI
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Zip | 53233-2703
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Country | US
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Telephone |
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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 | 6001539-15
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019.035535
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License Number State | IL
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